Church Road Dental Practice Manchester

Cancelling or changing an appointment 

Please complete the form below to cancel or change your appointment.

Alternatively please call the practice during normal opening hours.

Your first name
Your surname
Original appointment
Date & time
Who was your appointment with?
Date & Time of new appointment (if req'd)
1st choice
2nd choice
Your telephone
Your email
Although we take every precaution to ensure patient confidentiality we cannot guarantee that the information you provide on this form can be transmitted securely via the Internet. If you are concerned about this please telephone us.
76 Church Road  Northenden  Manchester  M22 4NW  tel: 0161 9983630  fax: 0161 9452448    find us