Self-referral to MSK Outpatient Physiotherapy

Self-referral to MSK Outpatient Physiotherapy (7)

Self-referral is available for adults over 16 who need support and advice to manage symptoms related to muscle strains/joint sprains/back and neck pain. This referral option is not available if you are under the care of a consultant for this problem, or if you have neurological, respiratory and/or continence conditions. If you have pregnancy related pain, please ask your GP/Midwife to refer you to the Pelvic Health/ Women’s Health Physiotherapy Service who do not currently accept self-referrals. Please note this is for patients who live within the Western Trust only.

Self-referral to MSK Outpatient Physiotherapy (7)

Please note that Direct Access Physiotherapy in the Western Trust is only available to prospective clients of 16 years and over. If you are not yet 16 years of age you will not be able to refer yourself for this service

As You are under a Consultant for this problem you will not be able to submit this form to Directly access Physiotherapy.

If you develop any new symptoms, after submitting this form, it is essential that you arrange for URGENT advice from your GP or attend your local Emergency Department.

If you HAVE NOT seen a doctor for this symptom, it is essential that you arrange for URGENT advice from your GP or attend your local Emergency Department, DO NOT submit your form.