If you have already had a sick note for this illness, you may not need to see your
Doctor to receive a subsequent sick note

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

Willow Tree Surgery
Telephone: 020 8842 1024

Yeading Court Surgery
Telephone: 020 8845 1515
About this form

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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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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

Willow Tree Surgery
Telephone: 020 8842 1024

Yeading Court Surgery
Telephone: 020 8845 1515
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.