For healthy, age-appropriate patients, Easy Access Colonoscopy enables you to undergo a screening colonoscopy without an initial consultation or visit.

Please have the following ready, to complete your enquiry form:

  • Current Medicare, Health Fund and DVA card/information
  • Current medications

Easy Access


Enquire for an EAC with Dr Yong

Easy Access Colonoscopy Request Form

01  Contact Information
Do you have Private Hospital insurance?*
Have you been with the fund for 12 months?
02  Who is your referring Doctor
03  Who is your current GP?
04  Reason for referral (tick which apply)
05  Have you had a previous colonoscopy
Have you had a previous colonoscopy?
If yes:
06  Patient Health Assessment
Are you pregnant?
07  Symptom Check (tick which apply)
08  Medical Condition Check (tick which apply)
09  Medication
Do you take blood thinning medication? (e.g. Clopidogrel, Dabigatran, Rivaroxaban, Apixaban, Aspirin,
Warfarin, Fish Oil)
List the medication & State the reason for blood thinning medication:
Do you take any other prescription, non-prescription or alternative medication?

List the medication

Do you take diabetic medications?

List the medication

10  Upload an image of Referral

File format: .doc, .docx

Upload failed. Max size for files is 10 MB.
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