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Referral form

The MCH podiatry service provides a paid-for nail care service and podiatry care for adults at Medway Hospital.

If you require community podiatry services please contact Kent Community Health NHS Foundation Trust >

Our specialist diabetes podiatry service at the Peter Simmons Diabetes Centre is for patient with diabetes who have an active foot wound or suspected/active Charcot foot.

Referrals to our podiatry services (not community podiatry) are accepted from healthcare professionals only. 

You can contact the appointment centre on 01634 471100, Monday to Friday, 8.30am-4pm.

 

Podiatry (foot care)

To find out how we use this information, our security and your rights visit our privacy page >

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GP details
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Emergency contact
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Reason for referral
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(use as much detail as possible)
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For example, does it disturb your sleep or interfere with your normal activities?
Which of the following applies to you?:
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(whether prescribed by your GP or bought yourself), any regular injections or complementary remedies (including vitamins)
Do you give consent for us to do any of the following:
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We ask the following questions about ethnicity and sexual orientation to ensure that it meets the needs of the demographic population of Medway.

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(where you would like the confirmation email sent)

You are welcome to bring someone with you to your appointment but you should bear in mind you will be asked details about your health problems and you may not wish to discuss these in front of your companion. There are no changing rooms at any of our clinics.

You will see a thank you page once the form has been submitted. If you do not see this page then you have overlooked to complete some of the required fields. Please check the form, complete the missing details and resubmit. Thank you.

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