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Colorectal Cancer Screening Assessment

Colorectal Cancer Questionnaire

Complete our questionnaire to see if you meet the criteria for a colorectal cancer screening.

1. Do you have one or more of these symptoms?

  • Bleeding when you have a bowel movement or blood in your stool (bright red, black, or brick red)
  • Change in bowel movements like diarrhea, constipation, or different consistency
  • Persistent belly pain such as cramps, gas, or pain and/or feeling full or bloated
  • Feeling like your bowel is not completely empty even after a bowel movement
  • Nausea or vomiting
  • Feeling tired more than usual
  • Losing weight without trying
2. Enter your age:

3. Do you have a family history of colorectal cancer or polyps?

You appear to have symptoms that require follow up with a gastroenterologist.

Please contact the Digestive Health Scheduling Center at 305-243-8644 (option 2, option 1).

To schedule an appointment online, fill out an appointment request form and request to see a gastroenterologist.

Based on this information, you do not meet the needs for screening at this time.

Please address any concerns you may have with your primary care provider.

You appear to meet guidelines for screening.

We evaluated your personal and/or family history and risk factors and believe that you may be a candidate for screening.

NCI Designated