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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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Providing care together in York, Scarborough, Bridlington, Malton, Whitby, Selby and Easingwold communities

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York and Scarborough Teaching Hospitals NHS Foundation Trust is registered, and therefore licensed to provide services, by the Care Quality Commission (Provider ID: 1-114394658). For more information, visit www.cqc.org.uk

Information for visitors

Norovirus is highly infectious and can spread easily

Please do not visit our hospitals if you or a member of your household has had nausea, diarrhoea, or vomiting within the last 48 hours. This is to prevent the spread of norovirus in our hospitals.

See more information on norovirus.