Reschedule an Appointment

Please complete the form below to reschedule your appointment:
Please note if the appointment you would like to reschedule is for breast screening we would ask that you contact the department directly via: BSUAppointments@wwl.nhs.uk or 01942 774 712.

Your Full Name*

NHS Number or Hospital Number*

Date of birth* Please use dd/mm/yyyy format

Address*

Postcode*

Tel No.*

Is this an Appointment or Admission

Which Would You Prefer?

Best Time to Call?*

Appointment Date* Please enter in the format: dd/mm/yyyy

Appointment Time* (e.g. 11:30 AM or PM)

Consultant

My Consent *

Royal Albert Edward Infirmary
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Edward Infirmary
Wrightington Hospital
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Hospital
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Infirmary
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