Cancelling your transport

1. First name

2. Surname

3. CHI Number (You will find this on your appointment letter)

4. Street Address 1

5. Street Address 2

6. Town

7. Post Code

8. Contact telephone number

9. Appointment details

Write your comment within 1000 characters.

10. Date when ambulance is booked

11. Name of clinic where your appointment is

12. Name of hospital where your appointment is

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