Family and friends test

Contact details


Practices part of First Care Group Practice

Heathrow Medical Centre
Telephone: 020 8754 1555

Shakespeare Health Centre
Telephone: 0203 794 3119

The Pine Medical Centre
Telephone: 0208 432 8569
About this form

Fields marked with a asterisk (*) are compulsory.
Please note that we will not respond to any medical information or questions received through the survey.

The information you supply us will be used lawfully, in accordance with GDPR Regulations. GDPR gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.

Please note that by using this form you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of registration.

Personal information retained on this system is stored in a secure data centre located in the UK and is treated as confidential.

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Please note, if you do not see the family and friends test form, you may have already given feedback.

Contact details


Practices part of First Care Group Practice

Heathrow Medical Centre
Telephone: 020 8754 1555

Shakespeare Health Centre
Telephone: 0203 794 3119

The Pine Medical Centre
Telephone: 0208 432 8569
About this form

Fields marked with a asterisk (*) are compulsory.
Please note that we will not respond to any medical information or questions received through the survey.

The information you supply us will be used lawfully, in accordance with GDPR Regulations. GDPR gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.

Please note that by using this form you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of registration.

Personal information retained on this system is stored in a secure data centre located in the UK and is treated as confidential.