Change or cancel an appointment

This form is for changing or cancelling an appointment only

Please complete the following form to change or cancel an existing appointment.

Change an appointment

Your details

First name(Required)

Last name(Required)

Email(Required)

An email address we can get back to you on

Home telephone

A telephone number we can contact you on

Mobile phone

A mobile phone number we can contact you on

Date of birth(Required)

The day, month and year you were born. (DD/MM/YYYY)

Post code(Required)

Post code

NHS Number(Required)

Your NHS number is 10 digits long and can be found on your medical card. Your NHS number is written on your medical history notes, so to find out what it is, you can ask your GP, or contact your local Primary Care Trust (PCT).

Your appointment

Date of appointment(Required)

The day, month and year of your appointment (DD/MM/YYYY)

Clinic or specialty(Required)

What would you like to do?(Required)

Change my appointment

Cancel my appointment

Additional details

Please help us re-arrange your appointment by letting us know if there is anything that will affect your availability, for example holiday dates.

Privacy(Required)

I can confirm that I have read, understood and accept the privacy policy.

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This form is for changing or cancelling an appointment only

Change an appointment

Your details

Your appointment