Cervical Screening Programme Deferral

 
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All questions marked with a * are mandatory

 

This form should be used if a participant's next test is to be postponed. The reason for postponement and new deferral date must be specified.
The participant will be invited for screening approximately 5-6 weeks before the end of the deferral period.

Participant Details
Deferral Reason (Please select only one)*: *
Practice Details

Next steps for Practices: Once completed and signed, please upload this form via the CSAS website. You should use the online enquiry form on the ‘Contact Us’ page and select the ‘Defer’ option. Keep the original copy in your files. 

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