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Cancel An Appointment

We have developed this section of our website for the convenience of patients who wish to cancel an appointment and who do not need to reschedule immediately. We will not return any email messages sent through this link.

Please note that complete physical examinations and appointments for pre-operative examinations require 24 hours notice of cancellation. If you do not provide 24 hours notice, you may be billed for the appointment you have missed. We do reserve the right to bill the patient directly for missed appointments without cancellation.

Please enter all of the information below including date and time of the appointment you wish to cancel.

PLEASE NOTE THAT WE CHECK MESSAGES REGULARLY DURING BUSINESS HOURS ONLY. WE WILL RESPOND TO YOUR ENQUIRY BY THE NEXT BUSINESS DAY. IF YOU HAVE SENT AN MESSAGE, YOU DO NOT NEED TO TELEPHONE US AS WELL.


Name:
Email:
 
Phone Number:
 
Date:
Your provider:
Image/photo:
Photo - to help in handling your request (max 10Mb):
Message:
 



Important information about this service
In using this on-line registration service you accept that you are submitting your name, e-mail, name of your doctor and other details through this website. This information will be used for the sole purpose of tracking and administrating your request.


While we take all reasonable precautions to safeguard your data, you acknowledge that the transmission of data through the Internet and the use of computing devices represent a risk beyond the control of the Family Health Team. We suggest you assume that all data transmitted through this service may be intercepted and analysed by third-parties, and that you only submit information on this understanding.

You acknowledge that this information will be stored electronically, in a secure manner.

You acknowledge that as a result of signing up through this service, you may receive e-mails containing registration information and other healthcare related information from the Family Health Team in the future.