{% extends 'base.html' %} {% load static %} {% block title %}Cancel Appointment{% endblock %} {% block content %}

Cancel Appointment

Appointment Details

Patient:
{{ appointment.patient.first_name }} {{ appointment.patient.last_name }}
Patient ID:
{{ appointment.patient.patient_id }}
Provider:
{{ appointment.provider.first_name }} {{ appointment.provider.last_name }}
Department:
{{ appointment.department.name }}
Date:
{{ appointment.appointment_date|date:"M d, Y" }}
Time:
{{ appointment.appointment_time|time:"g:i A" }}
Type:
{{ appointment.appointment_type.name }}
Status:
{% if appointment.status == 'scheduled' %} Scheduled {% elif appointment.status == 'confirmed' %} Confirmed {% elif appointment.status == 'checked_in' %} Checked In {% endif %}
{% if appointment.notes %}
Current Notes:

{{ appointment.notes }}

{% endif %}

Cancellation Details

{% if messages %} {% for message in messages %} {% endfor %} {% endif %}
Warning: This action will permanently cancel the appointment. This cannot be undone.
{% csrf_token %}
{% if form.cancellation_reason.errors %}
{{ form.cancellation_reason.errors.0 }}
{% endif %}
{% if form.cancellation_notes.errors %}
{{ form.cancellation_notes.errors.0 }}
{% endif %}
$
Enter cancellation fee if applicable {% if form.cancellation_fee.errors %}
{{ form.cancellation_fee.errors.0 }}
{% endif %}
Go Back

Cancellation Policy

  • Appointments cancelled with less than 24 hours notice may incur a cancellation fee
  • Emergency cancellations are exempt from cancellation fees
  • Patients will be notified of the cancellation via their preferred communication method
  • Cancelled appointments will be made available to other patients on the waitlist
  • Refunds for prepaid appointments will be processed according to the refund policy
{% endblock %} {% block js %} {% endblock %}