Self Referral to Physiotherapy

If you are registered with a GP in the South Eastern Trust area and you are over 16 years old, you can now refer yourself to Physiotherapy.

Suitable for those suffering from low back pain, neck pain, or recent injuries such as strains and sprains , or joint and muscular pain.

A direct route to expert physiotherapy advice and treatment

Promotes your ability to manage your problem and prevent it getting worse or returning

3 ways to access a referral form:

  1. Online form - A form can be completed online and submitted at the following link Online Physio Self Referral Form
  2. PDF form - forms can be downloaded and printed from the South Eastern Trust website Physiotherapy page
  3. Paper form - a copy of the form can be picked up at our reception or South Eastern Trust Physiotheraphy Departments.  Completed forms can be posted or emailed to the South Eastern Trust AHP Central Booking Office: