Cervical Screening - Request to Defer My Next Screening Date

Use this form to delay a future screening date and reminders for a period of time being sent from the National Screening Register for the National Cervical Screening Program.

Reason to Defer Screening *
  • I acknowledge that I can still screen at any time and the results will be recorded on the National Cancer Screening Register and can be viewed by my healthcare providers.
  • I may withdraw my request at any time by completing a withdraw request form, or by calling the contact centre on 1800 627 701.
  • I declare that I am the participant or their authorised personal representative.
  • I acknowledge that my selected request(s) will be actioned.
Acceptance of terms *