Ascenti NHS physiotherapy self-referral
Welcome to the Ascenti NHS physiotherapy self-referral form.
To use this service you must be a patient registered with a GP practice within the Wyre Forest and be 16 years of age or older. If you need treatment for more than one body part, you will need to complete a separate referral for each.
Due to the outbreak of coronavirus all our appointments are now taking place online.
To find out more about how an online physio appointment can achieve great treatment results click here.
While self-referral to physiotherapy is appropriate for the majority of people, there are some expectations where we would advise you to seek alternative medical assessment first.
Please do not complete this referral and call NHS 111 or immediately attend your local A&E if you have recently or suddenly developed, with the onset of low back pain and/or leg pain:
- A change in your bladder function or bowel control
- Altered sensation around your genitals or back passage
- Loss of sexual function
Please do not complete this referral and make an appointment with your GP if you have any of the following (your GP will need to complete a referral on your behalf):
- History of cancer, or being actively treated for cancer
- Unexplained weight loss
- Pain and/or altered sensation in both arms and/or both legs
- Have become unsteady on your feet
- You've noticed changes in your vision, speech or swallowing
- Have become feverish or are feeling generally unwell