Physio and MSK Self-Referral

If you are 16 or over and have are registered with Hampton Medical Centre you are able to refer to the MSK Physiotherapy Service for a range of muscle and joint problems including back/neck pain, joint pain, strains and sprains.

BEFORE SUBMITTING A REFERRAL PLEASE READ THE BELOW IMPORTANT INFORMATION:

If you have recently developed any of the following please consult NHS 111 or your GP before referring yourself to physiotherapy:

• Changes in your bladder or bowel habits, numbness or tingling around your back passage or genitals, numbness, pins and needles or weakness in both legs

Please discuss with your GP before submitting a referral if you have any of the following:

• A hot swollen joint
• Constant severe pain which you are unable to find relief from
• Unexpected weight loss
• Generally feel unwell or have a fever

Please follow the link – https://hrch.jotform.com/213222527065044

If you have any difficulties with the form please call 0208 714 4019