Therapy rehabilitation service referral form

Please refer patients to the therapy rehabilitation service based in the Drake Unit at Amersham Hospital  using attached referral form.

Once completed, please email the form to: bht.drakeunit@nhs.net

Please include the following information:

• Whether the referral is for Physiotherapy, Occupational Therapy or for a multi-disciplinary team Parkinson’s review.
• Patient details including their diagnosis, NHS number, telephone number, goal of treatment, onset and nature of current problem and urgency.