Order a replacement bowel test kit

Aged 50-74? Every two years you are sent a free, simple bowel screening test kit to do at home.

If you have not received a kit, or it is damaged, misplaced or expired, fill in the form below to order a free replacement.

If you are not sure whether you should order a replacement kit, please call our Contact Centre on 1800 627 701.

Request a replacement bowel test kit

All fields are required unless marked as optional.

Given Name(s) *

Family Name *

Date of Birth *

Medicare or Department of Veterans Affairs Number *

Postal Address *

Suburb *

State *

Postcode *

Phone

Reasons for replacement kit Kit was damaged when it was received Kit was not received Kit was incorrectly completed or not completed in time Kit lost or expired Other

Reason *

Authorised representative I am a healthcare provider or personal representative completing this form on behalf of a screening participant

If signing on behalf of the participant, please provide your name and contact information.

Please note: to fill in this form as an authorised representative, your details must exist within the Register as a personal representative. If you are not personal representative within the Register, we will not be able to process your request.

If you are unsure, please call our Contact Centre on 1800 627 701 before filling in this form.

Given Name(s) *

Family Name *

Date of Birth *

Postal Address *

Suburb *

State *

Postcode *

Phone

What is your relationship to the participant *

Relationship *

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Order a replacement bowel test kit

Aged 50-74? Every two years you are sent a free, simple bowel screening test kit to do at home.

Request a replacement bowel test kit

Important information

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