Cancel or re-book your outpatient appointment

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.

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.

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

First name

Last name

Hospital number

NHS number

Date of birth

Your phone number

We will use your telephone number to get in touch with you to confirm your identity.

Additional telephone number

If you use more than one phone number, please provide another number by which we can contact you on.

Your email address

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.

Your appointment

What would you like to do?

Cancel my appointment completely

Rebook my appointment

Appointment details
Specialty Date and time of appointment Date and time of appointment: Date Date and time of appointment: Time

Any other information

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.

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.

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Page last reviewed: 22 October 2022
Next review due: 22 October 2023