Physiotherapy Self-referral Form

• You live in North or South Lanarkshire
• You are aged 16 or over (if you are under 16 you will need to contact your GP about a referral)
• You are able to attend an outpatient appointment
• You are willing to engage in a course of rehabilitation which may incorporate behaviour and/ or lifestyle changes.

Completing this form will take around 10 minutes

Before you start

• MSK physiotherapy may not help you if you have already had physiotherapy treatment for the same condition in the past year. Please review the advice that your physiotherapist gave you and/or look at Musculoskeletal (MSK) Physiotherapy | NHS Lanarkshire (scot.nhs.uk) before you complete this self-referral
• Most initial physiotherapy consultations will take place face to face with follow-up appointments either by telephone, video call or face to face.
• Depending on your MSK condition you may be given the choice to attend for an initial group consultation or 1:1.
• The average number of appointments is between 1 and 3
• You and your physiotherapist will set jointly agreed goals
• We do not accept referrals purely for acupuncture
• Your referral will be processed and added to the waiting list. Our waiting list is prioritised depending on need. Our appointment service will contact you when you reach the top of the waiting list.
• You may be offered an appointment anywhere in Lanarkshire, however we do try to minimise your travel distance as much as possible.