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

  • The Case Registration form captures patient information and the exam date. A new case form is required for each exam, even if you have previously recorded a different CT exam for this patient.

  • 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:

  • Case Registration: v1.4
  • Exam: v1.5
  • Polyp: v1.7