Cancel Appointment Request

* Required field. Please note: you will need to fill in all required fields in order to submit your request to us.

* Patient Name

* Date of Birth

* Preferred Email

Parent or Guardian

* Preferred Phone Number

Brief Reason for Cancellation

* Date of your appointment?

* Which Location

Disclosure

Our practice will confirm the cancellation and notify you by email. We will make every effort to confirm the cancellation as quickly as possible.

However, to cancel an appointment that is to occur within 24 hours, you must call to assure cancellation before a missed appointment charge might accrue. Call: 603-537-1300. Our phones are answered live from 7:30 a.m. to 7:30 p.m. Mon-Thurs, 7:30 a.m. to 6:00 p.m. Friday, and from 8:00 a.m. until 2:30 p.m. on Saturday.

If you need to reschedule for another time, please use our Make an Appointment Form link that appears after you submit the cancellation.

Thank you.

Your cancellation request was received.

If you need to reschedule for another time, please call 603-537-1300 or use our Make an Appointment Form.

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Cancel an Appointment

Cancel Appointment Request

Disclosure

Thank you.

Your cancellation request was received.