NCSR forms

Participant details

Provide the Register with updates to your patient’s name, address, gender, contact phone numbers and email address, on behalf of your patient.

Indigenous and country of origin details

Allows you to provide information to the Register on your patient’s indigenous status, country of origin and preferred language, on behalf of your patient.

Self-care, Mobility and Communication Details

Allows you to provide information to the Register on any assistance your patient requires for self care activities, body movement activities, communication activities or interpreter services, on behalf of your patient. Note: this information is stored against the Bowel Program only.

Nominated Provider

Nominate a GP for your patient, with their consent, to receive their results (for the bowel program) and assist them and their participation in the program/s.

Personal Representative

Nominate a personal representative for your patient, with their consent, to assist representing them and their participation.

NBCSP - GP Assessment Report

Provide information to the Register where your patient is a Program participant and has received a positive iFOBT test result.

NBCSP - Colonoscopy Report*

To be completed by a colonoscopist to report the results of a colonoscopy for a Program participant with a positive iFOBT result.

This form also enables colonoscopists to report adverse events which may have occurred during the procedure or are known at the time of completing this form.

NBCSP - Adverse Events Report*

To be completed by colonoscopist to report information about an adverse outcome for a procedure relating to diagnostic investigation of a Program participant who has received a positive iFOBT result.

This form is only used where that information has not already been included in the Colonoscopy Report.

NBCSP - Histopathology Report*

To be completed by a colonoscopist or histopathologist to report the results from testing specimens collected during the colonoscopy procedure for a Program participant with a positive iFOBT result.

NBCSP - Replacement iFOBT Kit Request

Request a replacement iFOBT kit for your patient

NBCSP - Replacement Participant Details Form Request

Request a replacement Participant Details Form if your patient requires one.

NBCSP - Opt Out Form

Opt out the patient from the program.

Forthcoming bowel program results for the participant (screening test, dates and related procedure test results or diagnosis) are not accepted or recorded in the Register from the effective date, and no contact or correspondence is made or sent.

NBCSP - Opt in Form

Opt your patient in to the program.

On behalf of the participant, request that they are to resume participation in to the National Bowel Cancer Screening Program.

NBCSP - Defer Form

Defer you patient from the program for a defined period of time.

They may return to the program any time after the deferment period has ended or at any earlier time if they withdraw a request or if a screening test result is received by the Register.

NBCSP – Alternative Access Model (issue/re-issue form)

To be completed by the healthcare provider issuing an iFOBT kit directly to their patient.

NCSP - Abnormal Result Questionnaire

Provide information to the Register where a Program participant has had abnormal cervical screening results, and the Register has not received notice that a colposcopy has been performed.

The National Cervical Screening Program will send a letter to the Healthcare Professional to request this information where applicable.

NCSP – Add Total Hysterectomy Form

To be completed by healthcare providers to notify the NCSR when a patient has had a total hysterectomy. This will ensure the hysterectomy is accurately reported against their record, and no further invitations and reminders for cervical screening will be sent to them from the NCSR.

NCSP – Colposcopy and Treatment Form*

To be completed by a colposcopist to notify prescribed cervical screening information to inform participant clinical pathways and support the safety net function of the Register.

It is also used for reporting performance measures for colposcopists.

NCSP - Opt Out Form

Opt out the patient from the Program.

Forthcoming cervical program results for the participant are not accepted or recorded in the Register, and no contact or correspondence is made or sent from the opt-out date

NCSP – Opt In Form

On behalf of the participant, request that they are to resume participation in to the National Cervical Screening Program.

NCSP - Defer Form

Defer you patient from the program for a defined period of time.

They may return to the screening program any time after the deferment period has ended or at any earlier time if they withdraw a request or if a screening test result is received by the Register.

NCSP Cease Contact and Correspondence Form

Request that your patient no longer receive contact or correspondence from the National Cervical Screening Register (National Cancer Screening Register) for the cervical program. Note: Ceasing correspondence is not an option for the bowel program.