Health Promotion

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If you can no longer keep an appointment please telephone Reception on 605117 to cancel the slot which can then be offered to another patient. You may also cancel your appointment electronically using this cancellation form.

Facts

98% of patients booking an appointment each month attend the surgery.
However this means that 2% fail to arrive and this equates to 12 hours of lost clinical time.

Please keep your appointment or cancel it and allow someone else to use the appointment.

Please provide the following information...

Your Name: *
Please enter patient name
Email Address: *
Please enter a valid email address
Date of Birth: *
Please enter your birth date

Please enter dates as numbers - dd/mm/yyyy. Example 31st December 1958 would be 31/12/1958

Please give the details of the appointment you are cancelling...

Appointment Date: *
Please show the date of the appointment being cancelled
Appointment Time: *
Please enter the time of the appointment being cancelled
Who was the appointment with? *
Please select who the appointment was with.

Reason for cancellation (optional)...

Invalid Input