Cancel an Appointment

Please use this form to notify us if you need to cancel your GP 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 01325 520794.

Your Details

Title

First Name

Surname

Date of BirthPlease provide in the format dd/mm/yyyy

Are you able to provide your NHS or Patient Number?This will allow us to locate you quickly on our Patient Database.

NHS Number

Address

Post Code

Your Contact Details

E-mail Address

Home Phone Number

Mobile Phone Number

Appointment Details

Who is the appointment with?

Date of AppointmentDD/MM/YYYY

Time of Appointment

Comments

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Carmel Medical Practice • Nunnery Lane, Darlington, County Durham, DL3 8SQ.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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