Get Please Note This Form Should Be Used To Access Physiotherapy For One Musculoskeletal

Completing the Please Note This Form Should Be Used To Access Physiotherapy For One Musculoskeletal is a crucial step in receiving the care you need for your musculoskeletal complaint. This guide will walk you through each section of the form, ensuring you provide all necessary information to facilitate your physiotherapy access.

Follow the steps to fill out your physiotherapy access form correctly.

1. Click the ‘Get Form’ button to download the form and open it for editing.
2. Fill in the title and your NHS number at the top of the form. Ensure accuracy, as this helps with your identification in the healthcare system.
3. Provide your surname and first name, followed by your date of birth. If you are under 16 years old, note that a referral from your healthcare provider is required.
4. Enter your full address, including your postcode and contact telephone number. This information is vital for communication regarding your physiotherapy.
5. Record your email address for further correspondence from the physiotherapy department.
6. Indicate if you are unable to work due to this issue by selecting Yes, No, or Don’t Work.
7. List your general practitioner’s name and the address of their practice.
8. Describe your hobbies or activities you engage in and note any difficulties you experience in performing them.
9. Answer whether you have trouble sleeping due to this problem, specifying how many nights per week it affects you.
10. Clearly state your problem and identify the specific body part affected. You may also indicate its location on the provided diagram.
11. Mention if you have any sensations of pins and needles or numbness, and specify the locations if applicable.
12. Explain how and when your issue began, providing specific details for further context.
13. Indicate the progress of your condition since its onset: better, the same, or worse.
14. Disclose any recent treatments you have received for this issue, and explain their effectiveness.
15. Provide details of any relevant medical history and current medications. Respond to each condition listed by selecting Yes or No.
16. Submit any recent investigations related to your problem, such as X-rays or blood tests.
17. If applicable, indicate whether you have ever taken steroids or blood thinners.
18. List any allergies you have, providing explanations if necessary.
19. Name up to five daily activities you find challenging due to your condition, scoring how well you can perform them from 0 (unable) to 10 (no problem).
20. After completing the form, save your changes and choose to download, print, or share the form as needed.

Complete your form online and take the first step toward receiving the necessary physiotherapy.