Cervical Screening (Smear) Service

Please refer to the NHS Cervical Screening (Smear Test) Patient Leaflet to help you make an informed decision about whether to take part in cervical screening for your own health.

For translations in other languages, please click here.

After reading the leaflet, if you decide to defer, cease, or reinstate your cervical screening appointment following a previous decision to cease, please complete the appropriate form below. Submit the completed form in writing either by email to: highfield-surgery.noreply@nhs.net; or hand it in at our reception in person.

Please note that written confirmation is required in order for us to process your request to opt out of or rejoin our cervical screening recall system.

Forms:

If you wish to just defer the service for a few months or years, please use the form: Cervical Screening Programme Deferral

If you wish to permantently withdraw from this service please use the form: Informed Consent for withdrawal from the Cervical Screening Programme  –  This form should be completed once you still wish to withdraw from the programme after reading the patient leaflet.

If you are a patient representitive or a carer looking after a patient with mental capacity concern, please use the form: Ceasing from the Cervical Screening Programme – Mental Capacity Act (MCA) 

If you are aged over 65 without recent abnormal test results, or have radiotherapy to the pelvic area which affects the cervix, or have no cervix, please use the form: Ceasing from the Cervical Screening Programme

If you would like to reinstate into this service following a previous decision to cease (you don’t need it following a previous to defer), please use the form: Reinstate into Cervical Screening Programme

If you would like to opt into the service as a transgender individual, please use the following form: Gender Opt-In Form