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Physiotherapy self referral

You can refer yourself to Physiotherapy from this page

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Self-Referral Form for CD Integrated MSK Service (Physiotherapy)

Prior to completing this self-referral form please be advised that:

We can only accept self-referrals from patients (16 years or older) registered with a GP within the North Durham, Derwentside, Durham Dales and Easington/Sedgefield area.
Self referral to Physiotherapy for patients registered with a Darlington GP are commisoned though Connect Health (do not use this form) - see related links

If you experience any of the following, you need to seek attention via A&E
Numbness and/or altered sensation such as pins and needles around your back passage or genitals, e.g. when wiping after toileting. Sudden change with passing or controlling urine

If you experience any of the following, you need to speak to your doctor as soon as possible
Generally feeling unwell /night pain that does not settle with moving position
Back pain that starts when you have other problems, such as rheumatoid arthritis or cancer
Weakness in one or both legs that has not improved after one week/unsteadiness when you walk

Due to recent changes with how emails to the NHS accounts are handled, the online version of this form as been temporarily suspened until we can rectify this problem. 

Please download a copy from the right hand side and then return this form to:

AHP Central Appointments
1st Floor Education Building
Bishop Auckland General Hospital
Cockton Hill Road, Bishop Auckland
Co. Durham DL14 6AD


'As I was very, very nervous, I must have been the worst patient ever and they were brilliant with me and I can't thank them enough - could you please pass on my sincere thanks.'

Patient, Hysteroscopy Unit, Chester-le-Street Community Hospital