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Physiotherapy self referral


 We have changed our self-referral route. This means, one route – one form - one number. Please fill in this self-referral form (please download or save before completing). Find out more below.

What is self-referral?

Self-referral allows you to refer yourself our physiotherapy services without seeing a GP first.  

What can I self-refer for?

We are able to assess and manage many musculoskeletal conditions involving the muscles, nerves or joints. We are also able to assess many pelvic health conditions. We are able to accept referrals for anyone aged 16 and over. 

For any other problems, please contact your GP. If we receive your self-referral form and it is not appropriate for our service, we will let you know.

How do I self-refer?

Please use this self-referral form (please download or save before completing), following the instructions and providing as much information as possible. Also include any other medical conditions that may affect you (even if you think they don’t relate to the problem you are referring for).

Please let us know about any additional needs you may have in order to access our service, including interpreting needs. 

Please note: the Physio Advice Line number is no longer be available as the route into our service has changed as outlined above. 

If you're having problems and need support getting or completing the self-referral form, please call 0300 555 0123.

When should I self-refer?

If your GP or a healthcare professional has suggested you refer yourself to us, please use this self-referral form.

If you have a new injury or problem, it is worthwhile exploring our advice and leaflets section. Many problems improve with suitable advice and exercise.

However, if your condition is worsening or if you are in significant pain or feel you need urgent treatment, please contact your GP, NHS 111, or A&E as appropriate.

What happens after I self-refer?

Once you have completed and emailed the form to us at ccs.gateway.dynamichealth@nhs.net, you will receive a confirmation from us to confirm that we have received it.

Your form will then be assessed by a member of our physiotherapy team to identify the most appropriate person to see you, and you will then be added to a waiting list for an appointment.

When you reach the top of the waiting list you will be contacted by telephone or SMS text message to make an appointment. Waiting times can vary depending on demand. 

What do I do if I haven’t heard from you?

If you haven’t heard from us following a referral, or if your symptoms are getting worse, please let us know by phone call 0300 555 0123.