Cervical Smear Deferral

This form should be used if your next test is to be postponed. The reason for postponement and new deferral date must be specified.

You will be invited for screening approximately 5-6 weeks before the end of the deferral period.

Please note – if you submit this request after 4pm on a working day, it will be opened when we re-open on the next working day. The practice is closed over the weekend.

Cervical Smear Deferral

Section

Please use date format DD/MM/YYYY (maximum 18 months deferral)
Deferral reason: *
If applicable, please provide a copy of your recent test results:
Maximum upload size: 67.11MB