Referrers contact form

At Connect Health we work alongside a large network of health professionals for our patients. If you have a patient that you’d like to refer for one of our services, please complete the following form. We can contact the patient to arrange help and will keep you, the referring practitioner updated with any progress.

Please make sure you fill in all required (*) fields.

Maximum file size 5 megabytes.

GIVE US A CALL TODAY ON
0800 696 783

You don’t have to live with pain any longer. If you’ve got any questions or comments, or you’re ready to book an appointment, get in touch now. 0800 696 783.