Jump to content

Choose locationChoose Location
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
  • Locations
  • Sign in or Enroll
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Services
  • Gastroenterology
  • PAMF Gastroenterology Forms and Resources
Content

Gastroenterology Forms and Resources

If you are having a colonoscopy or upper endoscopy, please use these instructions or those given by your doctor. Don’t follow instructions from any other source, including those that come with your prescription preparation.

Please read our Frequently Asked Questions about colonoscopy. If you still have any concerns or questions, call the gastroenterology department at your procedure location.

Note:

  • Morning = use these instructions if your procedure appointment is before or at 12:00 pm.
  • Afternoon = use these instructions if your procedure appointment is after 12:00 pm.

Colonoscopy Preparation Instructions

Procedure Locations

  • Burlingame
  • Dublin
  • Fremont
  • Mountain View
  • Palo Alto
  • San Carlos
  • San Jose
  • Santa Cruz

With CLENPIQ

Dublin and Fremont only

  • Morning Instructions (PDF)
  • Afternoon Instructions (PDF)

With Magnesium Citrate

  • Instructions (PDF)

With MoviPrep

Morning Instructions (PDF) English | Spanish

Afternoon Instructions (PDF) English | Spanish

With PEG-3350 (Trilyte, Colyte, NuLytely, or GoLYTELY)

Morning Instructions (PDF) English | Spanish

Afternoon Instructions (PDF) English | Spanish

With Plenvu

  • Morning Instructions (PDF)
  • Afternoon Instructions (PDF)

With Su Tab

Instructions (PDF)

Colonoscopy Preparation Instructions with SuTAB (PDF)

With SUPREP

Morning Instructions (PDF) English | Spanish

Afternoon Instructions (PDF) English | Spanish

Morning, Single Modified Prep Instructions (PDF) Dublin and Fremont only

Morning, Double Modified Prep Instructions (PDF) Dublin and Fremont only

Food List (PDF) Dublin and Fremont only

Additional Important Information Regarding Your Colonoscopy (PDF)

For Patients with Diabetes

Diabetes Preparation Information (PDF) English | Spanish

Flexible Sigmoidoscopy

Flexible Sigmoidoscopy Preparation (PDF) English | Spanish

Flexible Sigmoidoscopy Preparation (PDF) Dublin and Fremont only

Upper Endoscopy Preparation Instructions

Procedure Locations

  • Dublin
  • Fremont
  • Mountain View
  • San Jose

Preparation Instructions

Morning Instructions (PDF)

Afternoon Instructions (PDF) Dublin and Fremont only

Related Content

  • Colonoscopy Frequently Asked Questions
  • Patient Rights and Responsibilities
  • Billing
  • Accepted Health Plans
  • Health Insurance Guide

Get Adobe Acrobat Reader

Download the latest version of Adobe Acrobat Reader.

The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

About Sutter

  • About Our Network
  • Annual Report
  • Awards
  • Community Benefit
  • Contact Us
  • News
  • Giving
  • Find Care

  • Birth Centers
  • Care Centers
  • Emergency Rooms
  • Hospitals
  • Imaging
  • Labs
  • Surgery Centers
  • Urgent Care
  • Walk-In Care
  • View All >
  • Featured Services

  • Behavioral Health
  • Cancer Services
  • Family Medicine
  • Home Health and Hospice
  • Orthopedics
  • Pediatrics
  • Pregnancy
  • Primary Care
  • Women's Health
  • View All >
  • Patient Resources

  • Accepted Health Plans
  • Classes and Events
  • Estimate Costs
  • Health and Wellness
  • Medical Records
  • Medicare Advantage
  • My Health Online
  • Pay a Bill
  • Symptom Checker
  • Our Team

  • For Employees
  • Physician Careers
  • Recruiting Events
  • Residencies and Fellowships
  • Sutter Careers
  • Vendors
  • Volunteers
    • ADA Accessibility
    • Contact
    • Privacy
    • Do Not Sell My Personal Information

    • LinkedIn Opens new window
    • YouTube Opens new window
    • Facebook Opens new window
    • Twitter Opens new window
    • Glassdoor Opens new window
    • Instagram Opens new window

    Copyright © 2022 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

    Cookie Policy

    We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

    Privacy Policy Cookie Preferences