Cancel or re-book an appointment

Use this form to cancel or re-book your outpatient appointment. You do not need to fill in this form to confirm you will be attending.

This form can only be used to cancel outpatient and clinic appointments booked by Barnsley Hospital. It cannot be used to cancel hospital admissions or appointments booked by other hospitals.

You will need the information on your appointment letter to use this form.

All personal data is held in accordance with data protection legislation. Information entered in this form will only be used to contact you about your clinic appointment, and not for any other purpose.

Please note:
If you fail to attend your appointment, or cancel your appointment for a second time, you may be discharged back to your GP.

About you
Your name*
First name Surname
Hospital number (optional)
NHS number (optional)

More information about your NHS number at NHS Choices
Date of birth*
Main telephone number*
We will use your telephone number to get in touch with you to confirm your identity.
Additional telephone number (optional)
Email*
Enter Email Confirm Email

We will send you confirmation by email that we have received this form, and will only use your email address to get in touch with you about the enquiry you are making today.
If you have any specific information or communication need, including whether you require an interpreter for your outpatient appointment, please let us know using the Any other information box below.
Your appointment
Appointment details*
Please let us know which department your are coming to, and the date of your appointment. If you need to change multiple appointments, please click the + symbol to add a new row.
Speciality Date
What would you like to do?*
You do not need to use this form if you are going to attend your appointment.
- Cancel my appointment completely
- Send me a new appointment
Any other information (optional)
Please provide us with any information that may be relevant so that we can aim to book you an appointment at a time convenient to you. Please also let us know of any dates and times to avoid booking your appointment. We will aim to book your appointment at a time convenient to you but this may not always be possible due to availability.
Phone (optional)
This field is for validation purposes and should be left unchanged.

How we use your data
We use information collected in this form only for purposes related to your enquiry. Read more about how we use data in our general privacy policy, or request a copy of your data.

Barnsley Hospital NHS Foundation Trust

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Cancel or re-book an appointment

About you

Your appointment

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Speciality	Date