Search the Herefordshire and Worcestershire Health and Care NHS Trust website

Advanced options

Community Physiotherapy in Worcestershire. Online Self-referral form.

If you live in Worcestershire, you can ask for physiotherapy by completing a form. We call this a self-referral form. You can do this without speaking to your GP.

Physiotherapy is helpful in treating problems with joints and muscles. If you are suffering from the following, please speak to your GP first.

  • Pain after a fracture or a fall in the last 12 months,
  • Carpal Tunnel syndrome
  • Fibromyalgia.

Before you fill out the online form. 

  • Have you been using the advice and tips on the self-help sections? You should try for at least 8 weeks. If not, you can access the self-help guidance here.
  • Are you still feeling pain, discomfort following the self management advice period?
  • Are you registered with a GP in Worcestershire? This includes Evesham, Droitwich, Pershore, Malvern, Tenbury, Worcester, Upton, Redditch or Bromsgrove
  • PLEASE READ – Have you read the important information regarding urgent and other symptoms below. You will need to check you don’t have any of these symptoms before continuing with the referral

If you have answered yes to all the above, please fill out the form. Please give as much detail as possible.

  • The form asks you for your body mass index (BMI). You can use the BMI Calculator to gain your score. Is gives a measure that uses your height and weight.
  • Enter your details and press 'submit' once. After we get your form, we’ll send you a "read receipt". This is to confirm it reached us. This will be from a “no-reply” e-mail.
  • If you can’t use the online form, call 0300 790 0599. The phone lines are open Mon to Fri 8:30 to 12:30. They will send you a paper form in the post to fill out.

IMPORTANT – Please Read before continuing with the referral 
Some symptoms need urgent medical attention not physiotherapy.

Do not complete this form if you have any of the following:
Urgent symptoms – go to A&E or call NHS 111 immediately
•    Loss of control of your bladder or bowels (for example, having accidents when you normally wouldn’t) 
•    Difficulty starting or stopping passing urine (peeing) 
•    Loss or change in the feeling around your genitals, buttocks, or inner thighs (for example, when wiping after using the toilet) 
•    Not being able to feel when you pass urine or open your bowels 
•    Sudden weakness in both legs causing difficulty walking (especially with your feet) 
•    Severe back pain that travels down both legs 
•    New problems with sexual function (for example, loss of sensation or difficulty maintaining an erection) 
•    Severe back pain following a recent injury or accident

If you have any of the following symptoms, please got to A&E or call NHS 111. Do not complete this form

Other important symptoms (contact your GP)
•    History of cancer 
•    Unexplained weight loss
•    Feeling unwell, fever or loss of appetite
•    Constant pain that does not improve, especially at night 
Please ensure you have completed a consultation with your GP prior to filling in the form

If none of these apply:
Continue with the self referral form via the link below

If you have answered yes to all the above, please fill out the form. Please give as much detail as possible.

  • The form asks you for your body mass index (BMI). You can use the BMI Calculator to gain your score. Is gives a measure that uses your height and weight.
  • Enter your details and press 'submit' once. After we get your form, we’ll send you a "read receipt". This is to confirm it reached us. This will be from a “no-reply” e-mail.
  • If you can’t use the online form, call 0300 790 0599. The phone lines are open Mon to Fri 8:30 to 12:30. They will send you a paper form in the post to fill out.

What happens after I have referred?

A physiotherapist will read your online form and decide what should happen next. We call this process triage. They will see how urgent it is. They will also decide how long it is until you hear back.

We will contact you by phone or letter and will offer you one of the below:

  • A face-to-face appointment with a physiotherapist. 
  • A phone appointment.
  • Refer to a specialist service.
  • Refer to the Joint Class.

After an appointment the physiotherapist may refer you to the Advanced Physiotherapy Practitioner Service. They may also refer you to other services such as:

  • Foot care (Podiatry). 
  • Functional restoration.
  • Strength or exercise classes. 

Contact

Contact 
You can call the MSK hub number for all self referral and appointment queries on 0300 790 0500. Lines are open Monday to Friday, from 8:30am to 12:30pm. We are able to check the progress of your referral or cancel/amend appointments. 

Phone Calls  
When we call you our number will show as either a private caller or withheld.
Text message reminders about appointments can be utilised. Our admin staff will check with you if you are happy for us to do this over the phone. You can also choose this via the online self referral form.