Refer Yourself

Self-refer to Physiotherapy

YourPhysio is the NHS musculoskeletal (MSK) physiotherapy service for people registered with a GP practice in York, Selby, and the surrounding areas.

We assess and treat people aged 17 years and over with musculoskeletal (MSK) conditions, including problems such as back and neck pain, muscle and tendon injuries, and osteoarthritis.

Who can use this service?

You can self-refer if you:

are aged 17 years or over

are registered with a GP practice in the Vale of York area (view GP practices we cover)

have a new, recurring, or long-term MSK problem

do not have an urgent medical condition or injury requiring immediate assessment (for example, an injury that needs assessment in an Emergency Department)

Who is this service not for?

This service does not provide physiotherapy for:

Neurological conditions
Cardiac rehabilitation
Children's (paediatric) physiotherapy
Pelvic health conditions
Respiratory conditions
Vestibular (dizziness and balance) conditions

Find information about other physiotherapy services: York and Scarborough Teaching Hospitals NHS Foundation Trust Physiotherapy pages.

GP practices we cover

To access this service, you must be registered with one of the following GP practices.

NHS York and Scarborough Teaching Hospitals NHS Foundation Trust staff members may also access this service.

Beech Tree Surgery	Haxby Group Practice	Park View Surgery	Stonedale Surgery
Clementhorpe Surgery	Helmsley Surgery	Pickering Medical Practice	Tadcaster Medical Centre
Copmanthorpe Branch	Heworth Green Surgery	Pocklington Group Practice	Tang Hall Lane Surgery
Dalton Terrace Surgery	Huntington Surgery	Posterngate Surgery	Terrington Surgery
Dunnington Surgery	Jorvik Gillygate Practice	Priory Medical Group	The Bishopthorpe Surgery
East Parade Medical Practice	Kirkbymoorside Surgery	Rawcliffe Surgery	The Old School Medical Practice
Elvington Medical Practice	Lavender Grove Surgery	Scott Road Medical Centre	Tollerton Surgery
Escrick Surgery	Millfield Surgery	Sherburn Group Practice	Unity Health Wenlock Terrace
Front Street Surgery, Acomb	My Health Group (Stamford Bridge/Strensall)	South Milford Surgery	Victoria Way Surgery
Fulford Surgery	North Duffield	Stillington Surgery	York Medical Group (all sites)

Self-referral form (PDF) for printing and completing by hand

The online self-referral form is our preferred referral method. If you are unable to use the online form, you can download, print and complete this paper referral form instead.

Please note that your referral will usually be processed more quickly if it is submitted electronically.

Refer Yourself

Are you in the right place?

Date of birth

Day:

Month:

Year:

Are you a York and Scarborough Teaching Hospital Staff Member?

Yes No

GP Surgery

Please be aware that if you are not registered with the GP practice you select then we may be unable to process this referral.

Continue

Refer Yourself

Self-refer to Physiotherapy

To access this service, you must be registered with one of the following GP practices.

Feet:

Inches:

Centimetres:

Unit:

Stones:

Pounds:

Kilograms:

Unit:

Refer Yourself

Self-refer to Physiotherapy

To access this service, you must be registered with one of the following GP practices.

Are you in the right place?

Date of birth

Are you a York and Scarborough Teaching Hospital Staff Member?

Which site do you work at?

Which department do you work in?

GP Surgery

You are referring to the York & Selby MSK Service. As you are registered to Pocklington Group Practice, you can either by seen locally in the GP practice or by a member of the Physiotherapy team in the York region. Please select your preferred area:

Do you have any soft tissue lumps or bumps in the body part you are referring for?

[REMOVED] Have you had recent surgery on this body part?

Do you have any fever symptoms including night sweats, fatigue, weight loss or nausea?

Do you have any metalwork in the body part you are referring for? E.g. Knee, Hip replacement or any metalwork in situ around the area of your current symptoms.

[REMOVED] Do you have a history of trauma (or think you may have a tendon rupture)?

Do you have a history of cancer?

[REMOVED]Do you have a history of prostate, breast, kidney, thyroid or lung cancer?

[REMOVED]Did you have spinal cancer?

What treatment did you have? Did you need major/radical surgery, radiotherapy or chemotherapy?

Do you have band like pain (pain around your torso)?

Are you unwell (fatigue / nausea / fever / stomach pain)?

Do you have mid back (thoracic) pain?

Are you experiencing altered sensation or weakness in your arms or legs? Do you feel uncoordinated or are losing your mobility?

Have you had any weight loss equal to 5-10% body weight over 3-6 months?

Select body region

Have you had a significant trauma in the last 2 weeks which caused deformity, significant swelling or bruising?

Have you had a significant trauma in the last 2-4 weeks which caused deformity, significant swelling or bruising?

Have you had a significant trauma in the last 4+ weeks which caused, significant swelling or bruising?

[REMOVED]Do you have widespread body pains?

Since the onset of your back pain, have you experienced any of the following symptoms?

[REMOVED]Do you have early morning stiffness lasting more than 30 minutes?

[REMOVED]Do you have persistent swelling of one joint or more?

[REMOVED]If you squeeze the joints are they painful?

[REMOVED]Do you experience night pain?

Select the option that most closely matches your symptoms

Have you had physiotherapy for this problem before?

Have you had a minor trauma which did not cause swelling, deformity or bruising?

In the last 2 weeks, have you had troublesome joint or muscle pain in more than one part of your body?

In the last 2 weeks, have you only been able to walk short distances because of your pain?

In the last 2 weeks, have you had to dress more slowly than usual because of your pain?

Do you have any other important health problems?

Do you feel it is unsafe for a person with a condition like yours to be physically active?

Have you had worrying thoughts about your pain a lot of the time in the last two weeks?

Do you think your pain condition will last a long time?

In the last two weeks, have you stopped enjoying all the things you usually enjoy?

Overall, how bothersome has your pain been in the last 2 weeks?

What treatment did you have?

Did the physiotherapy help?

If you are a military veteran or on active service, is this injury related to time served in the military?

If you are employed, are your symptoms affecting your ability to work?

If you are the main carer for someone else, are your symptoms affecting your ability to provide care?

[REMOVED] Since the onset of your back or neck pain, have you noticed any profound weakness in your arm or leg?

Did your back pain start when you were aged younger than 40?

Did your back pain develop gradually?

Does your back pain improve with movement?

Do you find there is no improvement in your back pain when you rest?

Do you suffer from back pain at night which improves when you get up?

Have you had symptoms for:

My back pain has spread down my leg(s) at some time in the last 2 weeks

I have had pain in the shoulder or neck at some time in the last 2 weeks

I have only walked short distances because of my back pain

In the last 2 weeks, I have dressed more slowly than usual because of back pain

It's not really safe for a person with a condition like mine to be physically active

Worrying thoughts have been going through my mind a lot of the time

I feel that my back pain is terrible and it's never going to get any better

In general I have not enjoyed all the things I used to enjoy

Overall, how bothersome has your back pain been in the last 2 weeks?

Do you have a pregnancy related problem?

Have you seen anyone from your GP Practice about the same problem?

When did you see your GP Practice about this problem?

Have you had surgery on the body part you are referring for in the past 6 weeks?

Have you had surgery on the body part you are referring for in the past 6 weeks?

When and where did you have your surgery? What operation did you have?

Have you had pain, numbness or pins and needles down your arm or into your hand in the last 2 weeks?

Patients with a history of cancer may require a GP referral to access the musculoskeletal physiotherapy service.

Please provide further information below. One of our team will review this information and write to you if the referral is rejected. Which type of cancer did you have? When was your diagnosis?

Thank you for self-referring to physiotherapy. We need to check we are the right team to assist you.

Which side is affected?

Which side is affected?

How long have you had symptoms?

If you would like email confirmation, please enter your email and press submit.

Please note we have received your referral and there is no need to contact your GP for a second referral.

Our admin team will be in touch with you when an appointment is available.

If you have a history of cancer we may ask that you see your GP to make sure you are being referred to the correct team. Please provide further details. Your answers will be reviewed and we will let you know if you need to see your GP first.

Which type of cancer did you have?