To qualify for a free screening direct access colonoscopy from North Texas Endoscopy Centers, you MUST first meet the below five criteria. (Confirm by checking all 5 of the following)
After meeting the above five criteria, a patient must then must qualify for a direct access colonoscopy, which allows them to receive a colonoscopy without first having a physician consultation. The following conditions would disqualify a patient from receiving a direct access colonoscopy, which would therefore disqualify a patient from receiving a free screening direct access colonoscopy.
By submitting this referral, you are confirming you are UNINSURED and meet ALL the required qualifications outlined above. (signature required below)
Please DO NOT CALL any of the North Texas Endoscopy Centers to check the status of your submission. Patients will be selected at random every month, and will be notified by our team.