Request equipment, adaptations or sensory loss rehabilitation: professionals

If you're a professional, you can use this form to request equipment, adaptations or sensory loss rehabilitation.

If your referral is urgent, or you need to report the breakdown of equipment, call 0161 217 6029.

Before you start

You'll need:

• the name, address, date of birth and contact details of the person you're referring
• details of any disabilities, sensory loss or medical conditions of the person you're referring, including if terminal
• the care and support needs of the person you're referring
• any risks for the person you're referring
• your name and contact details
• details of any equipment currently being used by the person you're referring
• details of your assessment
• details of the environment where the person you're referring is having difficulties. If possible, include photographs
• details of any equipment or adaptations needed so that we can 'fast track' it
• details of where grab rails are to be installed, if needed. Mark these during your assessment

Walking aids

We do not provide walking aids or rehabilitation for falls or physical difficulties. For more information, you'll need to contact the Adult Community Therapy Team.

Wheelchairs

We do not provide wheelchairs. You'll need to contact the NHS Wheelchair Service for more information.