Get As Pd Lft 0159 - Pdirect Self Referral Form - Cc&sc - V3 - Cuh Org

Filling out the AS PD LFT 0159 - PDirect Self Referral Form is an essential step for individuals seeking physiotherapy services. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the self-referral form.

1. Click the ‘Get Form’ button to access the self-referral form and open it in your preferred online editor.
2. Begin by entering your full name in the designated field to identify yourself.
3. Input your date of birth to confirm your eligibility for the service.
4. Provide your current address, ensuring that all details are accurate for communication purposes.
5. Fill in your daytime phone number and an alternative contact number so that the clinic can reach you.
6. Enter your postcode to assist with locating your nearest clinic.
7. Input your GP's name and NHS number to facilitate any necessary medical communication.
8. Describe the area of your body that you believe is affected and why you feel you need physiotherapy.
9. Indicate whether you have consulted your GP about this problem by selecting ‘Yes’ or ‘No’.
10. Record how long you have been experiencing the current problem.
11. Indicate if you are signed off sick for this issue and for how long.
12. Specify whether you have experienced this problem before and if you have attended physiotherapy for it.
13. Choose your preferred assessment site from the options provided in the form.
14. Sign and date the form, confirming that all information is accurate and complete.
15. Once completed, save your changes, and use the options available to download, print, or share the form as needed.

Complete your self-referral form online today to ensure timely access to physiotherapy services.