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Coming into hospital

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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Help us keep everyone safe this winter

We’re asking everyone to please help protect our patients, visitors and employees during the winter months.

If you’re feeling unwell, please don’t visit our hospitals - even for appointments or to see loved ones, unless it’s in exceptional circumstances such as end-of-life care or maternity.

Colds, flu, Covid and norovirus (sickness and diarrhoea) can spread easily and cause serious illness in vulnerable patients.

Please only come in once you’ve been free of symptoms for at least 48 hours.

When you do visit:

 Thank you for helping us keep everyone safe this winter.