Tan Tock Seng Hospital - Change An Appointment

CHANGE AN APPOINTMENT

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Change an Appointment

Please keep your appointment request within a year from your last visit. Requests beyond a year will be treated as new / first appointments.

**Patient's Name:
(as in NRIC/Passport)

**Patient's NRIC / Passport No:

**The appointment to change is on:

at this time: Hr Min
at this location:

Preferences

**Preferred Appointment Date is between

and
in the

Preferred Days of the Week:

Mon Tue Wed Thurs Fri

Preferred Doctor: (if any)
Please specify name of Doctor
Private charges apply for referrals to the Doctor by Name

Contact Information

Name:

Please type in name of contact person, if different from the name above

E-Mail:

Phone[Home]:

Phone[Office]:

Handphone:

Pager:

Fax:

Please call between

and

Please ensure information is correct for a hassle-free submission

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