Direct Enquiry

Cambridge Heart Clinic

Use this form to submit a request for further information, a quotation or indicative cost from the healthcare provider selected.  They will respond with further information or a quotation for your treatment.

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First Name*:
Last Name*:
Address 1*:
Address 2:
Email address*:

We would like your enquiry to be dealt with promptly and your questions answered effectively and efficiently, therefore please let us know which treatment, operation or test you are interested in.

Treatment of interest:

Please enter as much detail as possible about your enquiry.

Preferred contact method*:
Please let us know how you would prefer to be contacted
Preferred contact time:
Please let us know when would be convenient to contact you

Do you currently have private medical insurance?

IF yes, what month is it due for renewal?:

From time to time, Intuition (through one of our brands, including, may email you information about healthcare services that may interest you. Please let us know whether you are happy to receive occasional emails.

I am happy to receive occasional emails*:

By submitting this enquiry, I confirm that I, and anyone mentioned in this enquiry, explicitly consent to processing of any information contained in the enquiry (including references to personal health or similar information) for the purpose of actioning the enquiry and otherwise as set out in our Privacy Policy, and I also agree to the Terms & Conditions.

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