Cancelling Your Appointment

Cancel or rebook your clinic appointment

Use this form to cancel or rebook your outpatient appointment. You do not need to fill in this form to confirm you will be attending.

Please note:

This form can only be used to cancel or rebook clinic appointments. It cannot be used to cancel hospital admissions. You will need the information on your appointment letter to use this form and all mandatory fields are marked (*).
You cannot use this form to cancel an appointment that is less than 24 hours away.
All personal data is held in accordance with data protection legislation. Information entered on this form will only be used to contact you about your clinic appointment, and not for any other purpose.

About you

First Name (*):

Surname (*):

Date of Birth (dd/mm/yyyy) (*):

NHS no or Hospital no [help] (*):

Your contact details

We will use the contact details you provide to get in touch with you to confirm your identity. By providing this information you agree that we can do this. We need either an email address or a phone number in case we need to contact you.

Primary Contact Number:

Email address:

Clinic Information

Type of Appointment (*):

Follow-up appointment
New appointment

Specialty [help] (*):

Date of appointment (dd/mm/yyyy) (*):

Time of appointment (hh:mm tt) (*):

What would you like to do?

Please note that you do not need to contact us if you will be attending your appointment.

Choose from one of the following (*):

Please cancel this appointment. I do not need a new one
Please contact me to schedule a new appointment

Give reason for request (*):

Find your hospital and NHS numbers

Your hospital and NHS numbers can be found on the top right of the appointment letter to the right of your address details.

Your NHS number will consist of 10 digits which can be entered with or without spaces and the Hospital number is titled 'Our ref' and will consist of letters and numbers which should be typed as shown.

Find your specialty

Your specialty can be found in details listed in the middle portion of the letter or in the signature at the bottom of your appointment letter.

Please ensure that you select the correct specialty as per the appointment.

In the examples below, you would select Urology or Gastroenterology from the drop-down list on the form.