Colon Screening Program: Colonoscopy Referral Form
PHN NUM BER Colon Screening Program: Colonoscopy Referral Form Complete Provider and Patient Information PATIENT L AST NAME DOB OTH ERAL NU M(E . GRCMP , IY )
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Colon Screening Program
www.bccancer.bc.caWhat you should know: Health care providers should complete the Colon Screening Program Colonoscopy Referral Form and fax it to the Program at 1-604-297-9340.