Age *

Medical Conditions *

None

Currently being treated for Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), or any other heart-related issues

Kidney disease

On anticoagulants (blood thinners) and unable to pause treatment for 3–5 days

Under treatment for diverticulitis

Pregnant or possibly pregnant

Positive hemocult test

Crohn’s disease or active ulcerative colitis

History of endocarditis or rheumatic fever

Devices & Procedures *

None

Has a pacemaker

Difficulty with anesthesia during previous procedures

Oxygen-dependent

Other Considerations *

None

Does not have proper colonoscopy preparation

Any history that indicates significant risk or complications with the procedure

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