This form tells us you have been referred to our services by your GP, for the Physiotherapy, Orthopaedics, Rheumatology, Pain and Clinical Assessment Service (CAS). In order for the Adult Therapies Service to see your referral we require the Unique Booking Reference to allow us to triage your referral.

Once you have submitted this form, you do not need to call us, we will triage your form and determine which pathway best suits your needs. Once the form has been triaged you will be contacted by the administration team to book an appointment.

PLEASE NOTE: due to the current situation, we are unable to confirm when the administration team will call you to book an appointment. Your referral will remain in our systems and once the situation becomes clearer we will be in contact.

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Thank you for submitting this form, we will contact you. For any referral queries you can call 0300 124 3444.