Cancel your Appointment - Avon Road Surgery

If you are unable to attend an appointment at the surgery please use this form to let us know so that we can assign your time slot to someone else. We ask that you only use this form to cancel appointments more than 24 hours in advance.

Cancel an Appointment

Name *

Surname *

Date of Birth *

Address *

Address

Zip/Postal

City

Country

Current Email Address *

Main Phone Number *

Date of the Appointment *

Time of Appointment *

Who is the appointment with? *

Reason for cancelling / Additional Comments *

If you are human, leave this field blank.