Accessing the Service (Referrals)

We accept referrals from GPs, therapists and community nurses. To submit a referral, please click the link below to open the referral form. We do not accept paper, fax or telephone referrals.

To submit a referral you will require a password. To obtain the password please call 0114 271 5807 then choose the options for 'wheelchairs' and then 'appointments'.

Click here to complete a referral form 

Please only submit a referral from an nhs.net email account

If you have any difficulty opening/completing the form in the browser, please follow these instructions:

• Right click the link and choose 'Save target as' or 'save link as' and then click 'Save' in the window that pops up, accepting the default location of 'Downloads'.

• When the file has downloaded click ‘Open’ in the options at the bottom of the browser window. This should open the file in Adobe Acrobat. You will need to click on ‘Enable All Features’ at the top of the screen to activate the form.

• Once you have downloaded the form you will be able to open it directly from the 'Downloads' folder or find it in the recent file list in Adobe Acrobat.

Once your referral has been received we will contact you by letter to let you know what’s next. Therefore, it is important that the healthcare professional referring you has your up-to-date address.

If you already have a wheelchair from us, or you have previously been seen by our clinicians, you may be able to re-refer yourself without your GP or other healthcare professional having to submit another referral. In these situations, please ring our admin team on 0114 2715807.