Phishing or official

[#1]

Hi all, I received the email below yesterday
I'm afraid I was half asleep and under the affect of painkillers following an illness and for the first time ever I fell for it and filled out the form. I promise I have never fallen for this before, I was a little groggy and it looked so genuine (I know, they're meant to! lol)
That is assuming it is Phishing (I'm sure someone will tell me).
Thought I'd let everyone know.
What I want to know is what are the likely consequences and what should I do to minimise impact.
The details I gave were-
Full name inc. middle initial/home number/mobile number/D.O.B./Address and that's it as far as I remember.
BTW, if this is hookey any plusnet employee who sees this could perhaps note the Plusnet email address used and take some sort of action.
Thanks, any advice appreciated

image removed by op

[#2]

http://community.plus.net/forum/index.php/topic,141934.0.html
and I suggest you remove the image before the moderators do

[#3]

so it is genuine and this was posted on the forum. It's a shame after repeatedly telling us to ignore this sort of thing that they didn't email people the heads up, after all not everyone uses this forum, in fact I only came here about this because of the worry it caused me.
Anyway, panic over. I'm thankful I don't need to worry. Thanks for the link Oldjim.