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This form is for cancelling an appointment at one of our hospitals only.
Please complete the form below to notify us of your cancellation request.
If your appointment is today, please call the Contact Centre on 01904 726400.
Date of birth (DD/MM/YY)*
Would you like to recieve text reminders of your appointment*
Date of appointment (DD/MM/YY)*
Time of appointment*
Reason for the cancellation*
Can't make the day/timeAppointment no longer neededNot well enough to attendOther
If other, please specifiy why:
Would you like to re-book another appointment?*
* required fields
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