Request a Call Back

After making your booking, a member of our patient services team will contact you to discuss the appointment in detail and answer any further questions you may have.

If you would like to discuss anything prior to making a booking, please call us on 01752 437837. Before your visit, you will be asked to complete a questionnaire to ensure the package is tailored to your needs.

If you would like to see a specific Peninsula Heart Clinic cardiologist, have a specific symptom(s) or an existing heart condition, please call us to discuss prior to making a booking.

Full name

Sex

Male

Female

Do you have private medical insurance?

Yes

Date of Birth (day/month/year)

Contact telephone number

Preferred date to be seen

Urgently

In 1 month

In 3 months

Unsure

Brief history (reason for referral)

Please state the name of your consultant if you have previously seen a consultant cardiologist