Change Appointment

You can change an appointment by filling up this form. Once we have received your request, a representative from the hospital will give you a phone call to finalise your appointment.

Patient information

Patient's name *
(as in NRIC/Passport) 
Patient's NRIC / Passport No / FIN * 
Date of birth *
Gender * Please select... Male Female  

Appointment preferences

Current appointment date  
Preferred new date between *    and    
Preferred session * Please select... AM PM  

Contact information

Name * 
Email * 
Contact No. * 
Fax 
Verification code *
(case-sensitive)