Making, changing or cancelling your hospital appointment


Change an appointment/admission

Patient details
Do you want to change an appointment or an admission?
*First name:
*Family name:
*NHS number:
(This can be found on the appointment letter)
*Date of birth:    
*Address:
Email address:
*Daytime contact:
Add / update mobile number:
If you are completing this form for the patient tick this box:
Relationship to the patient:

Appointment/admission details
*Date of current appointment/admission:
<April 2017>
MonTueWedThuFriSatSun
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
*Time: :
Consultant:
Do you have / need any special services booked?:
Patient Transport
Patient Interpreter

Other relevant information

no more than approximately 60 words and
include how you wish to be contacted.


Review & terms and conditions
1. I understand that if you change this appointment/admission for me, that you will contact me with a new date.
2. If I have ticked the box above for patient transport, I understand that I will be required to contact the Transport Department on 020 7188 2888 option 2 for appointments at Guy's and option 3 for appointments at St Thomas' to rearrange transport for my new appointment.

  I have read, and agree to abide by the Guy's and St Thomas' NHS Foundation Trust Terms & Conditions