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You are here: Home > Coming into hospital > Cancel or defer your surgery or procedure

Coming into hospital

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Request to cancel or defer surgery

This form is for cancelling or requesting a change to your planned operation at one of our hospitals only.

Please complete the form below to notify us of your request.

Your details

NHS number

Full name*

Address*

Date of birth (DD/MM/YY)*

Telephone (home)*

Telephone (mobile)

Email*

Consultant name if known

Department

Reason for cancellation/deferral request*

If other, please specifiy why:

Email 2*:

* required fields

If your surgery is today, please call the Contact Centre on 01904 726400.

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