Forms & Procedure Instructions

MAGNESIUM CITRATE SHORTAGE INFORMATION: The US Food and Drug Administration (FDA) recently issued a voluntary recall on Magnesium Citrate Saline Laxative Oral Solution sold at several major retailers. For more information on this recall, please visit the FDA’s website. Capital Digestive Care offers its patients the ez2go prep kit, which contains a different brand of magnesium citrate that is not impacted by this recall. If you are not using the ez2go prep kit and are having difficulty obtaining magnesium citrate for your pre-procedure preparation, please contact your provider’s office directly for assistance and to discuss other options. Do not use milk of magnesia as a substitute for magnesium citrate.

New: click here to access Virginia colonoscopy prep instructions

Registration

  • Authorization to Release Medical Information Form  
    English
  • Billing Category Assignment of Benefits Form  
    English
  • Established Patient Registration Packet  
    English | Español
  • New Patient Registration Packet  
    English | Español
  • Notice of Privacy Practices  
    English
  • PIF (Medical History Form)  
    English
  • Patient Commitment to Safety Attestation (Covid-19)  
    English

DC Metro Colonoscopy Preparation Instructions

Please read and follow the instructions for the specific prep your provider has prescribed for you. Please visit your patient portal if you are unsure which prep you have been prescribed.

Clear Liquid Diet

Low Residue Diet

Other Procedure Preparation Instructions

  • EGD Prep Instructions  
    English Español |  Korean |  Russian 
  • High-Resolution Anoscopy Instructions  
    English
  • High-Resolution Anoscopy Instructions (Sedated)  
    English

Virginia Prep Documentation

  • Clenpiq Clear Liquid Prep for Colonoscopy  
    English
  • EGD Prep Instruction  
    English
  • Osmo Prep Clear Liquid Kit for Colonoscopy  
    English 
  • Peg Prep Clear Liquid Kit for Colonoscopy  
    English | Arabic |  Tagalong
  • Plenvu Clear Liquid Prep Kit for Colonoscopy  
    English