Resources for referrers
Making a Referral
For clients already known to the Wheelchair Service
For client’s that already have equipment supplied by the Wheelchair Service, there is no need to complete a referral form. Simply contact the Wheelchair Service Administrator with the person’s details and reason for re-referral.
020 7683 4250
*Please only send client identifiable information via the secure email domains nhs.net or hackney.gov.uk to adhere to information governance requirements.
For new clients
If a client does not currently have a wheelchair supplied by the Wheelchair Service, you will need to complete the Wheelchair Service referral form specific to your profession:
- GPs and Nurses
- Physiotherapist, Occupational Therapist or authorised Therapy assistants
Notes on the use of the online referral forms
- IMPORTANT: This form is currently designed for use with Adobe Acrobat or Internet Explorer. If you use other web browsers with non-Adobe PDF viewers (eg Chrome, Firefox, Edge), the form will not populate properly and may be returned. The Adobe Acrobat Reader can be downloaded for free here .
- All mandatory fields are highlighted in red and must be completed. If you do not complete all highlighted fields your form will be returned.
- Once the form is fully completed, save a local copy for your records, and then send it as an attachment to firstname.lastname@example.org. Please only send referrals from secure email domains nhs.net or hackney.gov.uk to adhere to information governance requirements.
- We recommend downloading the referral form from the Wheelchair Service’s internet page or Homerton intranet page each time you require it to ensure it is the latest version. We may not accept out of date versions of the referral form.