Refer Yourself

You can refer yourself if you:

  • have already tried physical therapy yourself (see guidance and exercises by clicking the links above)
  • have an MSK related issue/ condition
  • are registered with an Oxfordshire GP
  • are over 18 years old
  • are able to speak English
  • are not under the care of a hospital consultant for the same problem

You need to see your GP for a referral if you:

  • are aged between 1 and 18 years
  • are unable to speak English or only speak limited English
  • require post stroke rehabilitation
  • require home visits

HELP WITH TRAVEL COSTS……
If you are referred to hospital or another NHS Service such as Healthshare, you may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme (HTCS). Visit the NHS UK website to find out who is eligible for the scheme and how to make a claim using the HCT(T) Refund claim form.

By filling out this form and submitting it you consent to data being transferred via secure email.
We would be grateful if you could have your NHS number ready when contacting us or using this self-refer page. 



DEMOGRAPHIC INFORMATION

Please select an option

Please state in what capacity you know the patient

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Briefly explain what you have tried

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Please tick those that apply


Please enter your first name

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Date of birth*
Please enter your date of birth

**Please use the format DD/MM/YYYY**

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Please enter your county

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Please enter a valid email address

If you have provided an email address confirmation of your self-referral will be sent to you when you have successfully submitted the form.
Please check the spam folders within your email if you do not receive a confirmation in your inbox.

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Please enter your landline number

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If ticking email please enter your email address in the 'Email Address' box above

Please enter a GP name

Please enter the name of your GP surgery

GP surgery telephone number (if known)

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Please enter your NHS number

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CURRENT DIFFICULTIES
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Please tell us how long you've had this complaint

Please briefly explain why you need physiotherapy

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Some of the symptoms you have indicated may need more urgent care.
We do not think self-referral is suitable for you.
Please consult your GP or NHS 111 urgently.

You will not be able to submit the self-referral.

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Some of the symptoms you have indicated may need a GP consultation.
We recommend that you discuss these with your GP prior to making a self-referral.

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If you require a face to face appointment where would you rather be seen and at what time?
In order for us to plan your care please tick all days and times that are more convenient for you to attend an appointment. The service is open from 8am-6pm Monday to Friday.

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Please select a clinic

For clinic location details please go to Where We Do It

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EQ5D
Please place a tick in one box in each group below. Please indicate which statements best describe your own health state TODAY.

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If you click the Submit button and nothing appears to happen please check that you have filled out all the mandatory fields.

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