Colonoscopy Questionnaire
What a colonoscopy questionnaire asks, with sample questions on polyps, family history, medicines, and the ride home.
A colonoscopy questionnaire records the reason for the procedure, past colonoscopies and polyps, family history, medicines, and health conditions before a colonoscopy. It's also called a colonoscopy health history or a pre-colonoscopy questionnaire.
Colonoscopy questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a colonoscopy questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample colonoscopy questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Is this colonoscopy a preventive screening?Procedure reason
- Which symptoms, if any, led to this procedure?Procedure reason
- When was your last colonoscopy?Past colonoscopy
- Have you ever had colon polyps?Past colonoscopy
- Has a blood relative had colon cancer?Family history
- Has anyone in your family had colon polyps?Family history
- Do you take blood thinners or aspirin?Medicines
- Do you take insulin or a diabetes pill?Medicines
- Do you have sleep apnea or use CPAP?Health history
- Do you have a pacemaker or implanted device?Health history
- Who will drive you home afterward?Driver details
- What is your driver's phone number?Driver details
These are examples to read, not a form to fill in.
Colonoscopy questionnaire: FAQ
What does a colonoscopy questionnaire ask?
The sample questions on this page are based on the University of Iowa Health Care colonoscopy medical history form and the HealthPartners health history form. This page groups them into six areas: procedure reason, past colonoscopy, family history, medicines, health history, and driver details.
Who fills in a colonoscopy questionnaire, and when?
The patient, before the procedure. The HealthPartners form is completed at home and brought to the appointment, while University of Iowa Health Care collects its form online.
Why does it ask about current GI symptoms?
The University of Iowa Health Care form lists symptoms such as heartburn, bloating, and bowel habit changes. Its note says a patient who checks any of them is scheduled for a GI clinic visit before the procedure.
Is it the same as a colonoscopy health history?
It can be: University of Iowa Health Care titles its form Colonoscopy - Medical History Form. HealthPartners uses one health history form for colonoscopy and other GI procedures.
Does this page include bowel prep instructions?
No. Prep, diet, and medicine instructions come from the practice that performs the colonoscopy; the sample questions here cover health history and logistics only.
What happens after the colonoscopy questionnaire is completed?
The practice's team reviews the answers before the procedure. AI Doctor only collects them; it does not decide whether a patient is ready for the colonoscopy.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
