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Request to cancel or defer surgery

This form is for cancelling or requesting a change to your planned operation at one of our hospitals only.

Please complete the form below to notify us of your request.

Your details

NHS number

Full name*

Address*

Date of birth (DD/MM/YY)*

Telephone (home)*

Telephone (mobile)

Email*

Consultant name if known

Department

Reason for cancellation/deferral request*

If other, please specifiy why:

Email 2*:

* required fields

If your surgery is today, please call the Contact Centre on 01904 726400.

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Update for visitors

Visiting restrictions are in place at our hospitals to stop the spread of norovirus. These restrictions will be in place until further notice.

The following wards are closed to visitors:

There are four exceptions only to the restrictions. These are:

We understand these restrictions can be difficult when a loved one is unwell. The restrictions will be reviewed daily and lifted as soon as it is safe. Thank you for your understanding as we try to reduce the spread of norovirus in our hospitals.