Podiatry Referral Form

Referral

Anyone with a foot problem can refer themselves into the podiatry service by completing the referral form. To help our clinical team to prioritise we also need a photograph of your foot problem (if you are able).

If you have any problems completing the referral form electronically, please call the podiatry administration team on 01422 261313 who will be able to help you.

To help those with the greatest need the service will prioritise urgent problems, such as wounds and infection.

Our inclusion criteria is below:

People we seePeople we don't see
Podiatric (foot) needMedical needMusculoskeletal foot problemsNon-Eligible conditions

Ulceration / non-healing foot wounds

Foot infection which has required antibiotic treatment (excluding fungal nails)

In-growing toenail with infection / inflammation / pain

Painful corns

Painful, large areas of callus

Neuropathy (Loss of feeling)

Peripheral Vascular Disease (very poor circulation)

Rheumatoid / inflammatory arthritis

Foot ulcers

Immunosuppressed patients

Palliative / End of life patients

Foot pain from Musculoskeletal foot conditions such as plantar fasciitis

Severe foot deformities such as painful hammer toe or bunions.

Gait (walking pattern) abnormalities in children

Painful feet in children

General Nail care

Minimal or non-painful calluses or corns

Verrucae

Low risk Diabetes*

Fungal nail/ skin infections

*Annual diabetic foot screening is accessed via GP surgeries.

If you meet the criteria you will be offered an assessment, after which you may receive either:

  • Advice (and discharge from podiatry to continue self-management)
  • A one-off treatment
  • A course of treatment, as clinically required, to meet your foot health needs.

If you have a non-eligible condition NHS podiatry treatment cannot be provided.

All appointments will be allocated dependant on medical and podiatric risk and waiting times for appointments may vary depending on the treatment required.

If you feel you have met the criteria to receive NHS podiatry treatment, please continue to complete the podiatry referral form.

Patients that do not meet the criteria for access to NHS podiatry services can view our self-help information on how to safely manage your own foot care.

Alternatively, you can access the Huddersfield University podiatry foot clinic on 01484 472201 or email Podiatry.Clinic@hud.ac.uk, or a HCPC registered private podiatrist. Age UK also offer nail care services, they can be contacted on 01484 535994.

Refferal Form

Is the Referral for you?

Have you/the patient had previous treatment from this service?

Title*

Medication

Medical History*

Who currently provides foot care? Please mark as appropriate

Mobility Assessment

Are you/is the patient independently mobile (with or without a walking aid)?*

Transport can be arranged to bring you to a clinic appointment if you are able to travel in a wheelchair. A very limited service is available to patients who are totally housebound**. We may contact your GP for further information regarding this.
Definition of housebound:
A housebound patient is one who cannot leave their home at all, or without significant assistance which cannot be provided, either temporarily or permanently, due to severe physical or mental or illness or disability.

I require a home visit assessment because (please tick all that apply)

Is an interpreter required for your appointment?*

Please indicate your preference in the box below:*