From 1st November 2006, if you are a patient at Baddow Village Surgery, you can refer yourself to the Physiotherapy department for assessment, advice and treatment, without needing to see your Doctor first.

Open and print out the form below (or collect a copy from our reception desk), fill in the form and then either post, fax or hand deliver to Broomfield Physiotherapy department, (Address shown below).

An appointment will be arranged for you.

Download Physio Self Referral Form in Adobe PDF format

Download Physio Self Referral Form in Microsoft Word Format