Physiotherapy Self Referral

 
Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)
Personal Details
Please double check you've entered the correct email address

GP Surgery

Carlisle Healthcare, Locke Road, Carlisle, CA1 3UB

Consent & Additional Needs
Do you give us consent for contact on your contact telephone number?: *
Do you give us consent for contact on your email address?: *
If required do we have consent to view your medical records?: *
Referral details
3. Have you already seen someone about this problem?: *
4. Has your problem changed?: *
5. Have you had to stop work because of this problem?: *
6. Are you unable to provide care for a dependant because of this problem?: *
Additional Info

Pain Relief?
Over the counter painkillers can be helpful. A pharmacist will be able to advise you, if symptoms worsen you may need to contact your GP.

What can I do for myself in the meantime?
Resting may prolong pain and disability. You may need to modify your activities, but returning to normal is beneficial to your recovery. Changing your position or activity frequently through the day will help to prevent and reduce stiffness. Try to build up your general activity gradually. Further guidance is available at: www.versusarthritis.org and https://www.nhs.uk.

What happens next?
Complete the entire form it will be processed by Carlisle Healthcare and forwarded on to the NCIC Physiotherapy Department. Once received your referral will be reviewed by a physiotherapist and you will be contacted in due course to arrange an appointment. 

Privacy Consent

This form collects personal and medical informanot tion about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.

Care Quality Commission
Rating: Good

St Paul's Surgery
St Pauls Square
Carlisle
CA1 1DG

Telephone: 01228 588121

North Carlisle
Eden Street
Carlisle
CA3 9JZ

Telephone: 01228 588121

South Carlisle
Locke Road
Carlisle
CA1 3UB

Telephone: 01228 588121

Facebook