If you have been given an outpatient appointment at the hospitals and are unable to attend for whatever reason you can use the form below.
It is really important that you let us know of any changes as soon as possible. This means we can offer the original appointment to another patient.
Please complete the form below with your contact details and as much information as possible. You can find most of the information we need on your appointment letter.
If you have any problems using this form, please call the number on your appointment letter and we will do our best to help you. You will receive a response from us so you know it has been received and actioned.
If you wish to change the date and time of your appointment you, you can click the re-book option and state any dates that are not suitable for you, or you can contact us using the number on your appointment letter.
If you require advice about accessing your personal information the Trust’s Medico-Legal team can be contacted on access to your information the Trust’s Medico-Legal team at: firstname.lastname@example.org
The subject access form that we ask you to complete in order to gain access to your records can be accessed here
If you have any further queries on the uses of your information please speak to one of the following: Your healthcare professional. The Patient Advice and Liaison Service (known as PALS).
They can be contacted on 01925 635911. Our Data Protection Officer (Information Governance Manager) on 01925 635911 ext. 5673 or at email@example.com
Should you wish to complain about the use of your information please contact our complaints team using the PALS information above. If you remain unsatisfied with the outcome of your enquiry you can write to: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF or telephone them on 01625 545700.