Adult MSK Physiotherapy Self-Referral

You can now self refer yourself for physiotherapy without visiting your GP first by either of the following methods:

Complete a paper referral form. These can be collected from your GP surgery or collected from one of the addresses listed below. Once filled in, return it to one of the addresses below and we can triage the referral to the most suitable clinician.

Physiotherapy Departments

  • Boston House, Wigan Health Centre, Frog Lane, Wigan, WN6 7LB, TEL: (01942) 482260
  • Platt Bridge Health Centre, Rivington Ave, Platt Bridge, Wigan, WN2 5NG, TEL: (01942) 482403 
  • Leigh Health Centre, The Avenue, Leigh, WN7 1HR, TEL: (01942) 483413

Alternatively, please complete one of our online forms by clicking the relevant button below. Each button is linked to one of the Physiotherapy Departments listed above. 

Please note: If you have any of the following, please see your GP before referring yourself:

  • Changes in your bladder and bowel habits.
  • A hot swollen joint.
  • Constant severe pain and you are unable to find relief.
  • Weakness, pins and needles, loss of feeling.
  • History of cancer

Who is eligible?

  • Anyone over 16 years old who has pain or discomfort in their muscles, joints or ligaments. You must be able to attend one of our outpatient departments; this form is not for patients who require a home visit.

What happens once the form has been received by us?

  • Your referral form will be looked at by a Physiotherapist and we will decide whether we can help with your condition.
  • When we are in a position to offer you an appointment, we will contact you.

Whilst awaiting your appointment, helpful advice can be found on our Patient Information pages or the following websites:

If your condition changes after submitting your self-referral, please contact us for advice.


As part of providing you with direct care, the Trust may have to share your information with other partner organisations.  To find out more information about this, please refer to the Trust’s Privacy Policy.

By submitting this form, I agree to the Trust contacting me using the details given above.  I understand that the Trust will:

  • Securely store the information relating to my referral (and subsequent care, where applicable) in paper and/or electronic format
  • Keep the records for as long as required in the Records Management Code of Practice for Health and Social Care 2016 (or for longer if it is appropriate)
  • Confidentially destroy records when necessary
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