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Cancel Order Form

Cancel Order Form

Thank you for using the Sirtex Online Cancellation Form. Please complete the fields below to complete your request. After your cancellation is submitted, you will receive a confirmation of receipt from Customer Service. If you have any questions, please email csusa@sirtex.com or call us on one of our numbers listed on our Contact page.

Cancellation Request




Order Information

































* mandatory field


SIR-Spheres® is a registered trademark of Sirtex SIR-Spheres Pty Ltd.

Form 918e
Reference: QSOP06
COM-US-347

Revision #01 (CR2934) 26 May 2022