48-72 Hour Bravo Endoscopy (EGD) pH Monitoring Instructions

How to use this form
Enter the date and time of your procedure and click on the boxes next to the following medications that you are currently taking. Then view or print your procedure prep and medication instructions. Please inform the procedure scheduler if you have an allergy to nickel, as a different procedure will need to be ordered due to equipment.

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  • Current Medications (check all that apply)