Request to Change Appointment

To change 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 change is on

Preferred appointment date

Between and

Appointment to change is at

Hr Min

Preferred time

Preferred day(s) of the week
(tick accordingly)

Mon Tue Wed Thurs Fri Sat

Preferred doctor (specify doctor's name or Nil for none)

Location

(clinic)
(hospital)

Contact Information

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

Reply by
 (tick one only)

email
please call

FREE Registration
for personalised health services and information

About NetCare | Terms of Use | Terms and Conditions | FAQ | Contact Us
Copyright 2001 NetCare. V2.00.21. All Rights Reserved.
This site is best viewed using IE5.0 and NetScape 6.0 (800x600)

Disclaimer

All information found at this website is intended for educational purposes only and should not be
used as a substitute for consultation with your doctor. Although we try our best to ensure that
information is accurate at the time of publication, we are not responsible for any error, omission,
misprint or for any liability that results from the use (or misuse) of the information.
The views expressed belong solely to the authors and do not necessarily reflect the opinions of
NetCare and other members of NHG. The information may not be reproduced, compiled or
sold in whole or in part without written permission from NetCare.