This is a self-referral form for pelvic health physiotherapy. This form is for anyone aged 16 and over who is experiencing bladder, bowel and pelvic health problems (please note that we do not treat painful and heavy periods and for that you need to see your GP).
Self referral is another way of getting to see a pelvic health physiotherapist. It means you don't need to see the GP and wait for them to refer you.
Please note that the self-referral pathway is currently only for patients who are registered with the Sydenham Green Group Practice. Please do not attempt to complete the referral if you are registered with another GP as your referral will be rejected.