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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 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

Revision #01 (CR2934) 26 May 2022