Cancel an appointment

This form will be deleted from the end of December 2025. If you need to cancel an appointment after this date, please do so via our online admin form, or by calling us on 01296 310940. The online form can be found on your NHS App or on the front page of our website. Thank you for your understanding.

Personal Detail

Full Name *

Date of Birth *

Phone Number *

Email Address

Your Appointment details

If you cancel your appointment via this form and need to reschedule a new appointment please contact the surgery on 01296 310940 to rebook.

I understand that this form collects my name, date of birth and any other personal information that I choose to provide. This is to confirm I am registered with the practice; to allow the practice team to contact me and to update the medical records held by them and their partners in the NHS. I understand that I am able to read the privacy policy (Located at the footer of the website) to discover how they protect and manage my submitted data. *

I consent to the practice collecting and storing my data from this form and understand that anything not relating to this form will not be actioned.

Appointment Type *

Name of clinician or Nurse if known

Appointment date *

Appointment Time If known

Reason for appointment cancellation *

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Page last reviewed: 25 November 2025

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