Nottingham University Hospitals - NHS Trust
We are here for you
INTRANET

Bookmark and Share

Contact us about your nuclear medicine appointment

For other appointments click here

Please use this form to contact us to change or completely cancel your hospital appointment.

  • use this form regarding your own appointment at Nottingham University Hospitals Nuclear Medicine Department
  • you can use this form on behalf of someone else (e.g. a child or next of kin)

Please don't use this form to contact your GP or for research projects booked direct with the investigators.

Where boxes are marked REQUIRED, they must be filled in before you can submit the form.


The information you will need is on your appointment card or letter:
About the person who has the appointment:

Name
as on the appointment card/letter
REQUIRED

 
NHS Number
NHS or NUH hospital number
OPTIONAL (but very helpful)
Postcode
OPTIONAL (but very helpful)
Date of birth (day, month, year)
REQUIRED 		 
About the appointment:
Location
(please check boxes as appropriate)
Date of appointment that you wish to change
 REQUIRED 		 
Time of appointment that you currently have
 REQUIRED 		 
About contacting you:
Daytime telephone number or mobile number
If it is not a Nottingham number, please include the area code.
REQUIRED 		 
Address
E-mail address
Your request or message:
Please contact me - select carefully from the following options

I wish to cancel my appointment completely and do not require a replacement to be made

I wish to rearrange my appointment

I wish to ask you about my appointment

I prefer:

by phone (I have included my daytime phone number above)

by e-mail (I have included my e-mail address above)

by post (I have included my full postal address above)
I understand that if you completely cancel this appointment for me and I later change my mind, I will need to return to see my GP for a new referral. REQUIRED

I understand that I need to cancel or rearrange my own hospital transport and this will not automatically be done for me. REQUIRED
TRANSPORT

Please don't forget to cancel or re-arrange any transport that may have been booked for this appointment by phoning 0115 840 5898.

Any other message (you can use this to change your contact details or explain why you want to change the appointment). Please indicate any dates that you are unavailable.

Enter the code in the box below, and click the button to send your information to the hospital

Home | About | A-Z of Services | Patients and Visitors | Get Involved | For Clinicians | Staff Health & Wellbeing | Members | NHS Nottingham City | NHS Nottinghamshire County | Site Map
Access Keys | City Hospital campus maps | QMC campus map | Freedom of Information | Information Governance | Mobile Version

Website disclaimer | Privacy notice | Copyright notice | © Nottingham University Hospitals NHS Trust 2011

The Information Standard - Certified member   the NHS Constitution logo   Join the organ donor register

NHS - Blood and Transplant   NHS Choices   NHS Direct - 0845 4647   NaturalReader - Text to speech   Disabled Go   Smokefree   Smokefree

Valid CSS!