EWST - Referring Clinicians

The London Lithotripter Centre accepts referrals from Consultants, GP's and Physiotherpists from the central and greater London areas.

GP's and Physiotherpists

For GP's and Physiotherpists referring patients for ESWT treatment for soft-tissue conditions please complete the electronic referral form below and a member of our clinical team will contact the patient directly to discuss the treatments available and arrange a convenient time for the patient to attend our clinic. For more information please contact;

0151 525 2520

E-mail office@impactmedical.co.uk

Referrers Name

First Name

Last Name

Referrers Email Address

Referrers Practice Addres

Referrers Telephone Number

Patient Name

First Name

Last Name

Patient Telephone Number

Patient Date Of Birth

Patient Sex

Patients Condition For Treatment?

Previous Treatments For This Condition If Any?

Relevant Patient Information

Message

Information

I confirm that the information provided is correct and that the patient has given permission for their information to be shared with The London Lithotripter Centre and that they can be contacted for the purposes of ongoing treatment.

Yes

EWST - Referring Clinicians

The London Lithotripter Centre accepts referrals from Consultants, GP's and Physiotherpists from the central and greater London areas.

GP's and Physiotherpists

Clinic Days

For more information on our clinic days please click the link below

The London Lithotripter Centre