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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

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Patients Know Best

York and Scarborough Teaching Hospitals NHS Foundation Trust is now offering patients the opportunity to sign up to our new online service that gives you secure access to your health record from any smartphone, tablet or computer. It’s designed to improve your patient experience and access to NHS services and information. The service is provided in partnership with Patients Know Best (PKB).  Further information can be found on our website, including frequently asked questions.