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Sunday 15 September 2019
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Referral form for go2physio

You can access NHS physiotherapy without going to your GP first with go2physio. 


Physiotherapists are physical activity specialists working with you to enable you to manage your condition. They are expertly skilled to assess, diagnose, and manage patients with musculoskeletal conditions much in the same way as doctors. 


Musculoskeletal conditions such as muscle or joint problems like back pain, knee pain or sprains are best managed by Physiotherapists. Physiotherapists can transform people’s lives by:

  • Reducing pain
  • Improving quality of life
  • Keeping people out of hospital
  • Reducing disability
  • Reversing the deterioration of conditions

 

Physiotherapists will ensure that you will receive the most up to date and effective evidence based treatments for your problem.  Some physiotherapists are also qualified to administer injections or prescribe drugs without seeing your GP or Pharmacist.  For information about pain relief, please visit the NHS Live Well pages.


To self-refer via go2physio you  must meet these criteria:

  • You must be a Salford resident OR be registered with a Salford GP
  • You must be 16 or over

 

If you do not meet these criteria your referral will be rejected. Please see your GP.


» Indicates required fields

go2physio referral form
If "No" please complete this form.  Once the form has been completed it will submitted for review by an experienced physiotherapist and you will be provided with an appointment as appropriate. 
 
If "Yes", unfortunately we are not able to accept self-referrals for under 16s. Please book an appointment to see your GP.   
 
Personal details
Please select your full date of birth using the drop-down fields below - do not submit using today's date, as referrals received with this information will not be processed.
Please note - we only accept requests for patients who are 16yr olds and over
If you selected YES above, please state the language in the box below:
If you do not know your NHS number, please contact your GP surgery or look at any recent NHS correspondence
How did you hear about go2physio?  »
Presenting problem
Where are you experiencing your symptoms? »
If you answered yes, please indicate how many weeks pregnant you are - if not applicable, please leave the box blank.   
 
Please note if you are pregnant and plan to deliver your baby at Bolton you cannot access Salford services.  Please do not complete this form as we cannot accept your referral. 
Validation
For security reasons, follow the prompts below to prove you are a real person.
Captcha Image
Once your form has been successfully submitted the team will process it and an appointment will be arranged.  You will only get confirmation once an appointment has been made.
Please note - if you have clicked on the above Submit button and the form is still showing on the page, please scroll up and complete the missing fields marked in red "this must be filled in" in order to submit the form to the team.


Forms are sent onto us by our supplier via a non-secure email provider - for further information please see our disclaimer page.