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Oxford University Hospitals NHS Foundation Trust

Alert Coronavirus / COVID-19

If you have a new continuous cough, a high temperature, or a loss or change to your sense of taste or smell, do not come to our hospitals. Follow the national advice on coronavirus (COVID-19).

Please find information on our services and visiting restrictions in our COVID-19 section.

Patients and visitors must wear a face covering in our hospitals.

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Outpatient appointment request form

This form can be used to book, cancel and change outpatient appointments at the John Radcliffe Hospital, Churchill Hospital and Horton General Hospital

The Patient Contact Centre will deal with your request, usually within two working days. However, it may take longer if full details are not provided.

The information you submit via this form is secure. However, if you provide an email address in this form, we may contact you by email; these emails will include some or all of the personal information that you give us in this form. Please note that emails are not a secure method of communication. If you are concerned about your personal information being sent in this way, please telephone the Patient Contact Centre instead.

Patient Contact Centre (leave a voicemail out of hours and we will respond as soon as possible)
Tel: 01865 231405
Opening hours: Monday to Friday 8.00am - 6.00pm except bank holidays

If you would like to know more about how your information is processed or about your data rights, please see the Trust privacy notice.

Unless otherwise stated fields are required.

Your personal details

Your name

Please enter your name

Your date of birth

Please enter your date of birth e.g. 07 08 1969

Your address

Please enter your address

Your NHS details

Please enter your NHS number and GP details

Preferred contact method

Please choose how you would like us to contact you

Your reason for contacting us

Please let us know what you would like to do by completing the fields below.

What would you like to do?

Please choose one of the following

Consent

Please provide your consent for us to use the information you have provided

We will use the information provided for the purposes of processing your request to book, cancel or change your outpatient appointment. We will not pass your details onto third parties. For full details of how we collect and use your information, see our Trust privacy notice.