Cancel an Appointment - Dordon & Polesworth Group Practice

Please use this form to notify us if you need to cancel your GP or Practice Nurse appointment so that we can allocate the time to another patient. Please give as much notice as possible when cancelling appointments online.

If your appointment is today, please telephone the surgery on 01827 892893.

Non-urgent advice: Please note

This form is not for booking appointments.

No appointment allocation will be granted by completing this form for future appointment requirements.

Cancel an Appointment

Please select the practice location most relevant to this Online Form submission:

Name *

Surname *

Date of Birth *

Address *

Address

Zip/Postal

City

Country

Current Email Address *

Main Phone Number *

Date of the Appointment *

Time of Appointment *

Who is the appointment with? *

Reason for cancelling / Additional Comments *

If you are human, leave this field blank.