New Practice Application

Our carefully selected, managed network consists entirely of handpicked Chartered Physiotherapists and established clinics that offer a professional and friendly approach to patient care with a high emphasis on manual therapy.

The Physiotherapists within our network benefit from receiving high quality, triaged referrals and the opportunity to work with some of the UK's largest and most prestigious organisations.

We are always keen to hear from Chartered Physiotherapists who feel they would be a valuable addition to our network. If this sounds like you, then we look forward to receiving the completed registration form below and copies of your relevant insurance documentation.

If you have any further questions please do not hesitate to contact one of the team.

Practice Details
Opening Hours
Treatment Charges
Practitioners

Please note that practitioners need to have more than 4 years MSK experience

Additional required information
Declaration

I wish to apply for membership to Physio Med provider Network. The information I have supplied on this application form is accurate and correct.

I would like to register to receive referrals through the Physio Med Provider Referral Programme and will forward a copy of my proof of insurance.

I have read and agree to the Business Terms and Conditions. I understand that by submitting this form I am not under any obligation to accept referrals.

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