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Hard copy of Pilot SmartForm

The Participant Details (Health Centre Initiated) SmartForm is available in an electronic version for use as a hard copy by health practitioners taking part in the National Indigenous Bowel Screening Pilot. It is preferable to use the Online version of the form, but this may not always be practicable.

To obtain an electronic version of the form for printing, please contact bowelscreening@menzies.edu.au. This form is only to be used during the National Indigenous Bowel Screening Pilot.

Once you receive the form, follow all the instructions.

This form (or the online version) must be completed for everyone who is assessed for bowel screening.

Once completed, the paper form must be submitted via post or fax (address details provided on the form). Provide both Section A & B to the client to post with their samples.

Submission Instructions – Fax Section A to 1800 115 062 (free fax) or post a copy to NBCSP Register, Reply Paid 83245, Canberra BC ACT 2610.

Form Questions – contact the National Pilot Helpdesk at the Register on: 1800 319 300

Paper copies can be ordered by emailing: nbcsp@health.gov.au.

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