Appointments Cancellation

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Your Name: *
Your date of birth:
Your e-mail address: *
Telephone No: *
Appointment Date: *
Appointment Time : *
Clinician (If Known) *	Please Select Not Sure Dr Rowlands Dr Price Dr Allen Dr Edwards Dr Badger Dr Robinson Dr Morgan Dr Whatmore Other GP Nurse
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	BFN Cwmbran Village Surgery Secure Web Mail System

DISCLAIMER: We cannot be held responsible for problems with e-mail servers, internet connections, electricity failiures or any other event that will interupt the normal function of this service. We are bound by data protection acts. Data sent to us is not held on third party computers, and is soley used for its rightful purpose. Data recieved by practice in this way is not encrypted.

APPTCANCEL/MAR 07