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Services & Partnership

Partnership Opportunities Consultancy & Training Services Health Information Centre HealthZone at HPB Request New Appointment Change of Appointment Book HPB Facilities HealthLine QuitLine Accident & Emergency

Change of Appointment

Student's Full Name *
Student's Birth Certificate, NRIC or Foreign Identification Number *
Clinic Location *

Request for change of Appointment *

1. Clinic Service(s) *	2. Original Appointment Date and Time *	3. Requested Date and Time *
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Reason for request for change of appointment
	Note: Please note that the date and time that you have requested is subjected to the availability of appointment time slots in the clinic appointment scheduling system. Our clinic staff will contact you to inform you about the outcome of your request.

Parents/ guardians, please enter your particulars here

Name *
NRIC No *
Relationship to Student *
Telephone *	(Home)
	(Office)
	(Mobile)
Email *
	Send Reset

* Denotes Mandatory Fields