This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Find out more here. Hide this message

Contact us

Appointment Cancellation Form

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.

Your details

NHS number

Full name*

Address*

Date of birth (DD/MM/YY)*

Telephone (home)*

Telephone (mobile)

Would you like to recieve text reminders of your appointment*

Email

Your existing appointment

Date of appointment (DD/MM/YY)*

Time of appointment*

Consultant name

Department

Reason for the cancellation*

If other, please specifiy why:

Re-booking your appointment

Would you like to re-book another appointment?*

Email 2*:

* required fields

Find us on Facebook Follow us on Twitter
DSC_5694

A-Z of Services

IMG_4122

Feedback

Chinese Poland

View all languages >

Coronavirus - useful information

The latest health information about Coronavirus can be found at www.gov.uk/coronavirus.  Information about our local services can be found on this website here.

From Monday 15 June 2020, visitors and outpatients coming into our hospitals will be asked to wear a face covering at all times, to help us reduce the spread of Covid-19.  A face covering can be as simple as a scarf or bandana that ties behind the head.  It should cover your mouth and nose while allowing you to breathe comfortably.  For more information click here.

Hands Face Space