Please read the letter below, and acknowledge your understanding and receipt of it by checking the box at the bottom, then click the “Submit” buton. If you prefer, you can Print the form, sign it and bring it with you to your Appointment.


Dear ,

If you have selected to have “Open Access Colonoscopy” please read all the literature and call us if you have any questions.

We have scheduled your procedure without an office consultation, expecting your paperwork will be returned in a timely fashion. Once I receive all the paperwork, Dr. Share will review the history to confirm we can perform the colonoscopy without a prior office consultation. If we do not receive all the forms we may need to cancel and reschedule the procedure.

Please do not take aspirin or Advil type medicine for 5 days prior to your procedure( no bold). If you are on any blood thinners such as Coumadin, Eliquis, or Xarelto or Plavix, please let us know as these likely will need to be held for some days prior to your colonoscopy.

If you have any kidney disease or tend toward constipation please let us know.

Kindly fill out all the paperwork and submit electronically, or you can fax it to our office at 310-358-2266, before your appointment. Please upload a copy of the front and back of your insurance card(s). It is very important that we receive the enclosed paperwork at least 3 days before your procedure to prevent any delays. We will verify your insurance benefits and call you if there is any problem.

Please note that there is a fair amount to read as attention to detail is necessary to make sure you have a “perfect” colonoscopy!

Due to regulatory and insurance requirements you will need to sign a number of forms – it’s worth it!! Thank you very much.

Helen Beridon-Sweatt
Secretary to Dr. Edward J. Share


If you have any questions regarding this letter, please contact Dr. Share’s office.