Podiatry - patient self referrals

Patient Self referral information for patients in South East and South West Essex

If you live in Basildon, Rochford, Thurrock, Canvey, Southend or Rayleigh area and have a foot condition that fits our criteria and requires treatment, you no longer need to visit your GP, simply fill out the corresponding self-referral form to make a direct application for treatment.

How to self-refer into SEE Podiatry

Use the links below to download the appropriate self-referral form for the type of treatment you require.

• Please ensuring you have read and understood the referral treatment guidelines for the service you are applying to and complete every section in full.
• Failure to complete all sections can increase the chance of your application being-rejected.

Self referral forms

• Self-referral form for the treatment of In-growing Toes Nails
• Self-referral form for the treatment of General Podiatry/Chiropody Treatment
• Self-referral form for the treatment of Biomechanics/ Musculoskeletal assessments

Step 2 – Check your condition meets the criteria that is detailed within the application form.

Step 3 – Return your completed self-referral form either by post or email. If you need any help please contact the Podiatry appointments office on 01375 364465 and someone will be happy to assist you.

Send via email to: epunft.southeastpodiatry@nhs.net

Return by post to:
EPUT Podiatry Services
Ashingdon House
Rochford Hospital, Union Lane
Rochford
Essex SS4 1RB