Cervical Screening Programme – 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.

 

Cervical Screening Programme - Deferral

Cervical Screening Programme - Deferral

Patient Details

Please use format: DD/MM/YYYY
Please use format: mail@example.com

Please use date format DD/MM/YYYY (maximum 18 months deferral)
Deferral Reason:

Please provide a copy of your recent test results to the practice.