What you need to know

If you need to change or cancel your appointment, let us know as soon as possible. This is important because it:

may cause a delay in your treatment
will prevent another patient from being offered an appointment

Due to high demand, we may be unable to change your appointment. In these circumstances, we cancel your appointment and you go back onto the waiting list.

If you don’t contact us, you may be discharged from our service and a letter will be sent to you and your GP to advise you.

Changing or cancelling a Specialist Clinic appointment

Please complete this form if you wish to change or cancel a Specialist Clinic appointment.

If you wish to speak to a staff member about your appointment, please call us during business hours on 03 4215 1390.

All fields marked required are mandatory.

Name

This field is for validation purposes and should be left unchanged.

I would like to(Required)

Reschedule an in-person appointment

Reschedule a telehealth (video or telephone) appointment

Cancel an in-person or telehealth appointment

Request to change from an in-person appointment to a telehealth (video or telephone) appointment

Request to change from a telehealth (video or telephone) appointment to an in-person appointment

Patient Information

First Name(Required)

Last Name(Required)

Date of Birth(Required)

UR/Hospital Number

(6 or 8 digit number located underneath your name and address on your letter)

Current appointment information

Appointment Date

Appointment Time

Speciality/Clinic(Required)

The Speciality or Clinic information should be on your referral or appointment letter from Barwon Health. If unknown, select ‘Unsure’

Please select which Community Rehabilitation clinic you are attending

Reason for cancelling my appointment(Required)

Other(Required)

Requested change

I would like to change(Required)

The appointment time

The appointment date

Something else (please provide more information below)

What type of telehealth appointment would you like to request?

You are requesting to change a telehealth appointment to an in-person appointment. Please provide any additional information below.

Type of telehealth appointment

Comments or additional information

Details of person completing request

First name and surname of person completing request(Required)

Relationship to patient

Daytime contact number(Required)

Email(Required)

Enter Email Confirm Email

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Page last updated: September 8, 2025