Cervical Screening - Request to Opt Out

Use this form to opt out of all participation in the National Cancer Screening Register for the National Cervical Screening Program. Read important information about opting out of the NCSR.

 

Reason to Opt Out *
I wish to receive confirmation that this request has been actioned

View the privacy policy

  • I acknowledge that I will not be contacted or be sent any further correspondence from the National Cancer Screening Register (NCSR) for the National Cervical Screening Program. I can still undergo a cervical screening test at any time through a healthcare provider. No further cervical screening information about me will be recorded on the NCSR. My healthcare providers can be informed that I have opted out but will not be able to access my screening details.
  • 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 *