Long COVID Self-Referral West

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Are you aged 18 or over?
Do you have symptoms, which have persisted for more than 12 weeks following COVID-19 infection?
If you have any of the following symptoms, please ensure you have seen your GP before referring yourself to the Long COVID Service

To refer yourself, it is important that you complete ALL sections of the form clearly.  All information you provide will remain confidential and stored securely in line with Data Protection legislation and the organisation’s Information Governance policies and procedures. By completing this referral you consent for the Health Board to share necessary and relevant information with your GP or other appropriate healthcare professionals.

Has your GP ruled out other causes of your symptoms?
For example – blood tests, Chest X-Ray and ECG
You can now refer yourself directly to the BCUHB Long COVID Service

Symptoms of Long COVID include but are not limited to:
  • Fatigue
  • Breathlessness
  • Problems with memory and concentration (brain fog)
  • Mood changes (anxiety or depression)
  • Chest Pain
  • Heart Palpitations
  • Dizziness
  • Pain
  • High Temperature

What does the Service Offer?
  • Clinical, Psychological and Social Assessment
  • Advice, support and interventions to help you manage your symptoms
  • Access to Physiotherapy, Occupational Therapy, Dietetics, Speech and Language Therapy, Psychology
  • Referral to other services as required