INDEPENDENT PHYSIOTHERAPIST SERVICE
Please complete the form below to request a service from an independent physiotherapist
INDEPENDENT PHYSIOTHERAPY SERVICE
This service is provided by
KIMBERLY MORRIS BSc (Hons) Physiotherapy
Member of the Chartered Society of Physiotherapy (MCSP)
Her Specialisms are:
Paediatric and adult musculoskeletal physiotherapy, with particular expertise in infant developmental assessment; orthopaedics; neurodevelopmental management; neuromuscular and neurological conditions; and respiratory management involving suction and manual techniques training
Kim says: “I love working closely with parents, carers and healthcare professionals to provide sensitive and effective care”. To find out more about Kim
click here
Kim can provide the following services,
Initial Physiotherapy assessment costing £95
An assessment to establish the needs and make recommendations e.g for an EHCP assessment
Additional services, and additional costs:
Follow up Physiotherapy £60
Per session
Pre-tribunal Initial Assessment £165
Inclusive of assessment findings, joint range, strength assessment, postural analysis, background explanation of condition and general overview of movement pattern
Full tribunal report Additional £510, total £675
This would be completed after a Pre-tribunal Initial Assessment and provides Physiotherapy recommendations and objective measures like walking time, pre post intervention results, activities of daily living and how this impacts either the school location or the home location.
School Assessment
£
to be agreed
This will be calculated per hour, with mileage and travel costs accordingly.
For all services provided outside of Gloucester, mileage will be charged at 0.60 per mile from postcode GL46GA plus travel time
Following submission of this form you will be contacted to discuss your situation in more detail and to agree costs which must be provided in advance
.
Completing the Form
Please complete the form fully, giving as much information as possible.
Once you are at the front of the waiting list the physiotherapist will contact you to arrange a discussion of the services you wish to purchase
Details of person making the request
Please give the name of the person making this request
First Name
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Surname
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Email address
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Phone Number
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Please tell us a mobile contact number we could contact you on
Name and Address of person to be assessed
Please give the name and address of the person who is to be assessed
Name of person to be assessed
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Date of Birth of person to be assessed
Please give their date of birth
Address Line 1
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Address Line 2
Town
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Postcode
Please tell us so the physiotherapist can see you
Additional needs of Person to be assessed
Please highlight all that apply, hold down the control key and click to select.
Austism Spectrum Disorder
Global Development Delay
Learning Disability
Profound and Multiple Learning Disabilities
Physical Disability
Wheelchair User
Long Term Health Condition
Mental Health Condition
Sensory Impairment
Stoma/Gastrostomy
Tracheostomy/Severe breathing difficulties
Other
Please help us to understand the needs of your family
Cared for person's other additional needs
Service requested
Please highlight all that apply, hold down the control key and click to select.
Initial General Assessment £95
Pre-tribunal Initial Assessment £165
Tribunal assessment Plus Tribunal Report £675
Additional School assessment
Follow up Physiotherapy £60 per session
Please select the services that you are interested in
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