Cancelling an appointment

Please complete the form below, making sure you provide us with as much detail as possible.

This online cancellation form should only be used for Consultant and Physiotherapy Outpatient appointments, for all other appointments please contact the appropriate hospital on the contact details provided.

Please note for any cancellations within 48hrs, cancellation fees may apply.

To reschedule your appointment, please contact us using our live chat system or via 0808 101 0337.

*required field (cancellation form)

Patient details

Patient name*

Date of birth*

Email address*

Phone number*

Postcode*

Appointment details

EMPI / account number (from appointment letter)*

Hospital attending*

Consultant name (if known)

Appointment date*

Appointment time*

Reason for cancellation

Any additional information

I confirm I am the patient or have permission from the patient to cancel this appointment

We will use your personal information to process your enquiry and contact you with relevant information. For further information, please see our website privacy policy.

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