Small Bowel Capsule Endoscopy (EGD) PillCam Instructions – 12 Hour

How to use this form
Please enter your procedure date and time below to see your location specific check-in time on the next page. It is vitally important that you arrive at our facility at the check-in time, NOT at your scheduled procedure time. If you arrive at your scheduled procedure time, you are at risk for having your procedure cancelled. Then view or print your procedure prep instructions.

Procedure Date*
Month
Day
Year
Scheduled Procedure Time*

: Hours

Minutes

AM/PM
Procedure Location (check one)*
You must select the correct procedure location! Instructions are dependent on the location of service. If unsure, reference your text/e-mail or call 541-868-9505.
- Oregon Endoscopy Center in Northwest Specialty Clinics Building on Riverbend Campus
- Surgical Services at Sacred Heart Medical Center RiverBend Hospital