First physiotherapy referral

Use this service to request a physiotherapy referral.

If you are under 9 years of age or over the age of 79, please contact the surgery using our Get help for any health problem form.

Please do not use this form if you are requesting medication.

You can request a physiotherapy referral if you suffer from any Musculoskeletal (MSK) conditions listed below:

  • Upper back
  • Neck pain
  • Joint pain
  • Arthritis
  • Sports injuries
  • Soft tissue injuries
  • Muscles / ligaments
  • Foot problems
  • Rehab issues

You can use this service if you:

  • are registered at the surgery

Before you start

We’ll ask you for:

  • your first and last name, date of birth, sex, postcode, email and phone number
  • if applicable, the details of the person you are completing the form on behalf of
Start now

You can also phone us on 0118 940 3939.