Tracking and Improving Screening for Colorectal Cancer Intervention

6.a-2 Feedback Form for Stool Test Negative

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Colorectal Cancer Screening Feedback Form for FIT Negative Patients


Below is a list of patients in your practice who participated in the SATIS-PHI/CRC screening program and had a NEGATIVE fecal immunochemical test (FIT-) result. The date of the result is included.

Patient status was determined on the basis of a medical record review and inspection of administrative data.

All patients with a NEGATIVE FIT (FIT-) result should be notified of this result and informed that the U.S. Multi-Society Task Force guidelines recommend that they should be rescreened every 12 months.

If you have any questions related to the information provided here, please call our office at [INSERT HERE: CONTACT PHONE NUMBER].



Patient Name ID Number FIT+ Result Date CDE Status

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Page last reviewed October 2014
Page originally created September 2012
Internet Citation: 6.a-2 Feedback Form for Stool Test Negative. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD.