Patient Self Referral Information

You are able to refer yourself for certain treatments, please see details below for the available self referral services.

Hospital Physiotherapy Referral Service

To be referred to the Hospital Physiotherapy Service please complete the self referral form below, and send to the address on the bottom of the form.
UHL Physiotherapy Self Referral Form

Podiatry Self Referral Application

Please complete the self referral form below and send to the address stated on the form.
Podiatry Self Referral Form

Open Mind Self-Referral Information

• You can telephone the Open Mind Service on 0116 292 7010; or
• You can complete a short online form on the Open Mind Service website