You CANNOT use this form if your appointment is:
in X-ray, CT, MRI or Ultrasound
for a maternity or obstetric outpatient or ultrasound
Instead, please phone the relevant department directly, the number will be located on your appointment card or letter.
- This form is ONLY for hospital outpatient appointments
- You can use this form for your own appointment OR on behalf of someone else (e.g. a child or next of kin)
- The information you will need is on your appointment card or letter.
If you wish to cancel more than one appointment on the same day then you will need to complete separate forms.