Please note, the Outpatient Call Centre and Referral Management Hub should not be utilised for the following services:

Renal Outpatient

Cancer Outpatient (Oncology, Haematology, Medical Oncology)

Pain Management Unit Outpatient (TQEH)

Burns Unit Outpatient

Oral Maxillary and Dental Services

Palliative Care

Cardiology

Neurosurgery

Rheumatology

Neurology

Diabetes and Endocrinology

For cancellations or rescheduling during business hours, please call on 1300 153 853.

This form should only be used outside of business hours by patients who have a scheduled OPD appointment. If you do not have an appointment please do not use this form.

Change or Cancel your Outpatient Appointment

About the patient

First name *

Last name *

Date of birth *

UR or Hospital Number

What is your current appointment date & time?

Appointment date *

Appointment time *

Clinic *

I would like to

If you cancel or reschedule your appointment, it may result in a longer wait for your next appointment.

Reason for change

Please outline your reason

Reason for cancellation

Contact details

As you have requested to cancel or change your appointment, we may need to contact you. Please provide your details below.

Are you the patient?

Yes No

My name is

As you have said you aren't the patient, please let us know your name

My relationship to the patient is

Please let us know your relationship to the patient

Best daytime contact phone number *

Alternate number

Preferred contact time

Email

You will not receive correspondence from the OPD for appointments, we will simply email you a receipt of your form submission.

Have any of your contact details changed?

Do you need to update your address, phone number or GP details? (If any of these have changed, please update below – otherwise you can leave this blank).

Any other information?

If there's anything else we might need to know, include it below – for example the reason you are changing or cancelling your appointment.

Is the emergency department the best place for you?

Change or Cancel an Outpatient Appointment

Please note, the Outpatient Call Centre and Referral Management Hub should not be utilised for the following services:

For cancellations or rescheduling during business hours, please call on 1300 153 853.

Change or Cancel your Outpatient Appointment

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