Alder Hey Children's NHS Foundation Trust

Change or Cancel Your Appointment

You can use this form if you wish to change or cancel your appointment. Please help us by providing all the information required. (* Required information)

Warning: When you send information to the Internet, it might be possible for others to see that information.

The Patient Access Centre telephone number is 0151 252 5358

Your details

Reference number:

Last name*:

First name*:

Date of Birth*:

Address*:

PostCode:

Telephone:

Appointment details

Appointment date & time*:

Consultant name/ Speciality*:

Reason for change:

New appointment required:

Yes

Please indicate when you are NOT available e.g. hoidays, exams, etc and whether AM or PM:

Security question - to validate your reply please choose todays date

You will be notified by post of a new appointment.

Tel: 0151 228 4811 - Fax: 0151 228 0328
Send feedback here | 0065543