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Please fill in the following information to reschedule or cancel your COVID-19 vaccination.

The purpose of this form is to enable patients to inform the health board that they wish to re-arrange their COVID-19 vaccination appointment to a more suitable time.

Cardiff and Vale UHB is the data controller for any personal data that is collected. Any data entered will be used to process your rearranged appointment or to record the intent to opt out within the vaccination electronic record.

The lawful basis for processing data under the UK GDPR is Article 6(1)(e) and Article 9(2)(h), and your data will be retained in line with the Records Management Code of Practice 2016/2020.

For any complaints in relation to how your data has been handled, please contact:

To see more information in relation to see how your information is processed, please see our privacy policy notice.




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