Please use this online form to:  

  • Upload and submit a request to CSAS to delay/defer a patient from call/recall
  • Send a query regarding an existing enquiry about one of the above forms

Before proceeding with this online submission, please ensure you have downloaded and completed the relevant cease/defer/reinstate form which can be found on the CSAS website.

 ** Please note: To ensure we can create a unique case reference number for each enquiry, you can upload and submit one patient request on this form.**

The online form will ensure the quickest possible response time to your requests and queries. You will be prompted for all the information CSAS needs to process your request. 
Once you submit your form, you will receive an acknowledgement email.