Cancel Your Appointment

Please let us know as soon as possible if you are unable to make your appointment by completing the form below. THIS FORM SHOULD ONLY BE USED IF YOUR APPOINTMENT HAS BEEN SET FOR MORE THAN 24 HOURS IN ADVANCE. If your appointment has been arranged for a time within the next 24 hours, please call Reception directly on 01202 897989 for our Corbin Avenue surgery or 01202 874302 for our Glenmoor Road branch.

Last Updated: 07/04/2023

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Date of Birth (DD/MM/YYYY) *

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Appointment Details

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Name of Doctor or Nurse

Appointment Date *

Appointment Time *

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. *

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