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SANTA BARBARA GASTROENTEROLOGY CONSULTANTS MEDICAL GROUP Name: __________________________ Facility: ☐ Santa Barbara Endoscopy Center ☐ Santa Barbara Cottage Hospital Procedu x e Date: _________________ Check In Time: __________________ ☐ Santa Ynez Cottage Hospital COLONOSCOPY PREPARATION SHEET: GOLYTELY/ DULCOLAX 5 Days Prior 4 Days Prior 3 Days P