Kid Glove House

01942 481638


Patients can now self-refer for physiotherapy without visiting the GP first by filling in this form:

Adult MSK Physio Self-Ref Form

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

Fill in all the boxes on the second page of the form and either post, email or hand deliver that page to one of the Physiotherapy Departments listed below

 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

 Please note these email addresses are for referrals only, and as such you must not use the email to contact department for any other purpose. Unless an email is encrypted the security of that email cannot be guaranteed.

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 the physio outpatient departments; this form is not for patients who require a home visit.

What happens once the form has been handed in?

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