Request to Cancel Appointment

To cancel an appointment with NHG institutions, fill in the form below. Text boxes in red indicate required information and upon completion, click 'submit'.

Patient's name

NRIC/Birth Cert/Passport No

Medical discipline referred to

If unsure, specify medical conditions/symptoms

Preferences

Appointment to cancel is on

Appointment to cancel is at

Hr Min

Location

(clinic)
(hospital)

Contact Information

Requester's Name (enter name if requesting on behalf of patient)

Reply by
 (tick one only)

email
please call

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