Endoscopy Procedure
Endoscopy Details
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What was the name of the procedure?
*
Was an endoscopy performed?
No
Yes
Start date of endoscopy.
01 Jan 2000
Start time of endoscopy.
12:00
End date of endoscopy.
01 Jan 2000
End time of endoscopy.
12:00
What was the bowel preparation procedure agent used?
Magnesium citrate
Polyethylene glycol
Other
If "Other", specify.
What date was the bowel preparation started?
01 Jan 2000
What time was the bowel preparation started?
12:00
What was the individual dose of the agent per administration?
What is the unit of the agent per administration?
Choose
CAPSULE
g
IU
mg
mL
PUFF
TABLET
ug
What was the route of administration of the agent?
Choose
INTRALESIONAL
INTRAMUSCULAR
INTRAOCULAR
INTRAPERITONEAL
NASAL
ORAL
RECTAL
RESPIRATORY (INHALATION)
SUBCUTANEOUS
TOPICAL
TRANSDERMAL
VAGINAL
Were any biopsies taken?
No
Yes
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Mandatory field