Appointment Cancellation Request Appointment Cancellation / Amendement Request If your circumstances have changed, please complete the following form so arrangements to ammend your appointment can be made. Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Please enter the code provided by your sponsoring company. Note this code is non-identifiable *Appointment Change Type *Re-scheduleCancellation Appointment Change Reason *Unable to make this time nowScheduling conflict Unhappy with TherapistPersonal (outside of work) reasonOther (If Other please indicate below)Suggested Date / Time *DateTimeOther Reason For Requested Appointment ChangeAdditional Comments or MessageWebsiteSubmit follow us.