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If you think you need Physiotherapy

Physio Self-Referral Picture

you may not need to see your GP

You now have the option of referring yourself to the

Musculoskeletal Physiotherapy Outpatient Service

Are you suitable for Self-Referral?

1) Please read the leaflet attached to see if you think you qualify  Physio Patient Self-Referral Leaflet

2) If you believe you are suitable, please fill in PART A of the following form ONLY Patient Self-Referral Form for Physiotherapy

3) If you have answered NO to ALL the questions in PART A, please fill in PART B and send the form using one of the methods below:


Scan / email to:

Fax:  01722 425 258

Post: Physiotherapy Outpatients, Level 3, Salisbury District Hospital, Odstock, Salisbury, SP2 8BJ

Please note you can also pick up Self-Referral Forms from Reception

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