Patient Registration Form. Patient Information. Name (First / Middle Initial / Last):. Date of Birth: Marital Status: Single. Married. Divorced. Widowed.COLONOSCOPY PREPARATION INSTRUCTIONS. Prepopik. WHAT IS A COLONOSCOPY? (abnormal growths of tissue) also may be removed and bleeding areas may be The following instructions are your physician's specific instructions. Please follow the instructions carefully to ensure a successful prep. Even if the patient has no symptoms, the procedure will be classified as a diagnostic colonoscopy if a polyp is found and removed. Furthermore, other findings To achieve optimal examination of the colon, it is imperative to completely remove all fecal matter before the procedure. Inadequate cleansing of the colon Colonoscopy prep instructions are extremely important for a successful colonoscopy. Most cases of bleeding occur in patients who have polyps removed. THREE days before the examination, eliminate intake of fruits, vegetables, nuts, Detailed discharge instructions will be furnished prior to your. Follow the Prepopik Patient Instruction Sheet (enclosed with the kit): often used to screen for colon cancer with the goal of removing polyps (small. Colonoscopy – Prepopik Instructions. APPOINTMENT CONFIRMATION: Patient Name: Wear comfortable clothing that is easy to remove and leave jewelry at home.