Bowel 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 Cancer Screening Register for the National Bowel Cancer Screening Program.

We require an email address so we can contact you if there are any issues processing your request. If you prefer not to share your email or do not have one, please call our Contact Centre at 1800 627 701.

Reason to Defer Screening *
Authorised personal representative

Fill in the form below so we can process your request.

To fill in this form as an authorised personal representative, your details must be registered with the NCSR as the screening participant’s personal representative, otherwise 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.

Any personal information provided to the NCSR, including your email address, will only be used to assist in processing this request.

For more information on how personal information is handled, view the privacy policy and frequently asked questions.

  • 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 NCSR Contact Centre on 1800 627 701.
  • I declare that I am the participant or their authorised personal representative.
  • I acknowledge that my selected request will be actioned.
Acceptance of terms *