University Hospitals Coventry & Warwickshire

What is your enquiry about?

First name

Last name

Date of Birth

Contact number

Email address

Reasons for Enquiry

Which hospital was your appointment with?

Do you know which department or clinic the appointment was with?

Are you requesting to

Date/Time of appointment that was made

Do you need a letter resending?

Please let us know any more details so we can help to match your requirements if we can

Do you have any special needs or requirements for your care?

Yes No

Please specify your special needs or requirements

You no longer require an appointment

Yes No

Are unable to meet the timings of the appointment but would like another one booking?

Yes No

Your condition has improved so you don’t feel you need this?

Yes No

Have you been able to access treatment or support elsewhere?

Yes No

Which of our sites do you have questions about?

Is this about

Enquiry details

Dr Michelle Christie-Large (Consultant)