Cancel An Appointment

Please use this form to notify us if you need to cancel your GP appointment so that we can allocate the time to another patient. Please give as much notice as possible when cancelling appointments online.

If your appointment is today, please telephone the surgery on 028 9065 4018.

Name

Date of Birth

Address

Post Code

Appointment Details

Type to cancel:

Appointment with:

If you know the name of the Doctor or Nurse your appointment is with please provide the name here.

Date of Appointment

Time of appointment

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Knock Medical Centre • 423B Upper Newtownards Road, Belfast, BT4 3LH.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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