Physiotherapy Self-referral Form

Routine physiotherapy

Please note that there is an increased waiting time for routine physiotherapy due to the Coronavirus pandemic.

Please refer to the information and advice in our website to help you manage your condition effectively while you wait to hear from us Musculoskeletal (MSK) Physiotherapy | NHS Lanarkshire (

Self-referral criteria

You may use this self-referral process if:

  • 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

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 ( before you complete this self-referral
  • Most initial physiotherapy consultations will take place by telephone with follow-up appointments either by telephone, video call or face to face.
  • 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.