The Veterans Health Administration (VHA) Gastroenterology Program aims to provide high-quality colonoscopies and timely communication of the procedure results. At our VA medical center, the previous colonoscopy pathology letters were brief and potentially unclear for patients unless significant information was manually added. Additionally, some veterans had voiced confusion regarding the implications and recommended follow-up outlined in the letters. The goals of this quality improvement (QI) project were to: (1) to measure baseline patient comprehension and satisfaction with the current colonoscopy pathology results letter, (2) to use Veteran and GI provider input to revise the letter, and (3) to measure patient comprehension and satisfaction with the revised letter.