Cancel an Appointment

We are not the Northern Care Alliance/ Salford Royal/ Hope Hospital. All forms filled out for appointments held at the hospital will not be actioned. Please only fill this form in if you are cancelling an appointment made with the University Health Centre Salford

Please use this Form to cancel appointments more than 24 hours in advance. If you are unable to attend an appointment please let us know in plenty of time to assign your appointment time to another patient.

First Name *

Last Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Appointment with

Date of Appointment *

Time of Appointment *

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

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