The attached PDF forms are available for your convenience to collect and organize CTC data prior to online data entry. 

  • The Registration form captures the patient’s demographic information and can be used to enter patient information in the Patient Dictionary.

  • The Exam form captures data from the patient’s colonography.

  • The Polyp form is required only if a polyp of at least 10mm in size is detected during the exam. 


You may download each form separately, or download the entire form package as a single file.


Please do not mail the printable forms to the ACR.


Versions:

  • Registration: v1.6
  • Exam: v1.9
  • Polyp/Lesion: v1.8