Tracking and Improving Screening for Colorectal Cancer Intervention
Tool 2.b-3 Screening Tracking Sheet for Practices
|Patient Name||Patient ID||DOB||For CX Screens||For Stool Test Screens||For Stool Test Positive Screens|
|CX Results Received||Patient Notified of Results||Patient Returned Stool Test Kit||Stool Test Kit Sent to Lab||Test Result Received||Patient Notified of Results||Result Positive||CDE Recommended to Patient||CDE Completed||CDE Results Received|
Key: DOB = date of birth; CX = screening colonoscopy; CDE = complete diagnostic exam (diagnostic colonoscopy).
Page originally created September 2012