Auto-Cancellation Form

PLEASE NOTE: if the cancellation request is within 3 days of the shift start date, the cancellation will not be processed. To check that your shift cancellation request meets this criteria, please select the earliest date of the shift(s) you would like to cancel in the shift details section. If the date is unavailable, please contact our Bank Bookings team on 020 7959 1119, option 1.

Please select whether you are a Bank Worker, Agency or Trust Department*

Bank WorkerAgencyTrust Department

Agency Name*

Agency Email*

Is the cancellation request from the Trust Department or the Candidate?*

Trust Name*

Department Name*

Department Contact Email*

Candidate First Name*

Candidate Last Name*

Candidate Email*

Earliest Shift Date You Want To Cancel*

Staffing Group *

Unfortunately, we do not provide Ancillary staffing options for GOSH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 1170.

Unfortunately, we do not provide Ancillary staffing options for BHR, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 188 1917.

Unfortunately, we do not provide Ancillary staffing options for HRCH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0330 236 9101.

Unfortunately, we do not provide Ancillary staffing options for Kingston, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 577 3411.

Unfortunately, we do not provide Ancillary staffing options for North Middlesex, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 577 0013.

Unfortunately, we do not provide Ancillary staffing options for Moorfields, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 3550.

Unfortunately, we do not provide Ancillary staffing options for Portsmouth, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 577 3316.

Unfortunately, we do not provide Ancillary staffing options for UCLH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0207 959 3550.

Unfortunately, we do not provide Ancillary staffing options for Whittington, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 577 3023.

Unfortunately, we do not provide Medical staffing options for GOSH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 1170.

Unfortunately, we do not provide Allied Health Professional (AHP) staffing options for GOSH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 1170.

Unfortunately, we do not provide Admin & Clerical (A&C) staffing options for GOSH, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 1170.

Unfortunately, we do not provide Medical staffing options for Moorfields, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 020 7959 3550.

Unfortunately, we do not provide Medical staffing options for North Middlesex, therefore you will not be able to submit a cancellation request. If you need assistance please contact our bookings team at 0333 577 0013.

Shift Information (please input the BRN as numerical digits only & make sure both shift date and BRN are filled out)*

Has the shift already been cancelled?*

Is the cancellation for a theatre nurse?*

If 'Yes', please select the type of theatre nurse*

Is the cancellation for West Moreland Theatres or Tower Theatres?*

Cancellation Reason (please select the most relevant cancellation reason)*

BHR Cancellation Reasons (please select the most relevant cancellation reason)*

GOSH Cancellation Reasons (please select the most relevant cancellation reason)*

Kingston Cancellation Reasons (please select the most relevant cancellation reason)*

Barts Cancellation Reasons (please select the most relevant cancellation reason)*

Cancellation Notes (if required)

0/100

Does the shift require recalling?*

Please select a recall reason (GOSH)*

Please select a recall reason (Moorfields)*

Please select a recall reason (North Mid)*

Please select a recall reason (Portsmouth)*

Please select a recall reason (Whittington)*

Please select a recall reason (UCLH)*

Please select a recall reason (Barts)*

Please select a recall reason (BHR)*

Please select a recall reason (HRCH)*

Please select a recall reason (Kingston)*

Are you interested in booking any future shifts?*

Please provide your contact number below and one of our bookings agents will be in contact*

By ticking 'Yes' below you confirm that all the information above is correct*

By providing your details and submitting this form, you confirm you have read and understood our privacy policy. We only share your personal details with our group companies at bankpartners.co.uk/affiliates and those categories of third parties in our privacy policy at https://www.bankpartners.co.uk/privacy-policy/

BANK Cancellation Form

Requester Information

Shift Details

Cancellation Reason

Further Information