Request a FIT

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First Name:*

Last Name:*

Birth Year*

Birth Month*

Birth Day*

Address:*

City/Town:*

Province: *

Postal Code: *

Phone:*

Email:*

How did you hear about the ColonCheck program?

Online (email, Facebook, ads, etc.) Bus ad Radio Newspaper Billboard ad Television My doctor told me Poster or pamphlet

Oops! Did you lose or make a mistake doing a test we recently mailed you?

Check here if this is a request for a replacement test.

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Most Manitobans 50 to 74 years of age should complete a FIT every two years. We invite you to request a FIT using the form below if you are age 50 to 74 and:

have not completed a FIT or FOBT in the past 2 years,
have not had a colonoscopy in the past 10 years, and
are not experiencing symptoms such as:
- persistent abdominal pain or change in bowel habits lasting for several weeks,
- visible blood in your stool, or
- unexplained weight loss.

If you are experiencing these symptoms, speak with your healthcare provider. If you need a healthcare provider, call the Family Doctor Finder at 204-786-7111 or 1-866-690-8260.

Be sure the information you enter on the Request a FIT form matches the information on your Manitoba Health Card. If you have moved and not updated your Manitoba Health Card, visit the Update your Manitoba Health Care site for information on how to update your Manitoba Health Card.

FIT Instructions

Click here to open the instructions.

English

French

FIT instruction videos in Cree and Ojibwe languages can be found here.

Contact

1-855-95-CHECK (1-855-952-4325)

Interpreter services available upon request.

ColonCheck@cancercare.mb.ca

For more information please contact:
CancerCare Manitoba
Phone: (204) 787-2197
Toll-free: 1-866-561-1026

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