Please only complete this form if you have pregnancy related pelvic girdle pain.

If you have given birth in the last 12 months, please complete the separate Perinatal Pelvic Health self-referral form.

Alternatively, you can call and register a self-referral: 0161 922 4888 (option 3).

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Please note this is for a group session that is led by a specialist pelvic health physiotherapist, you will be given a treatment plan and asked to complete if for four weeks following the group.

If there is no improvement you can book back in for a one-to-one appointment to address any specific issues you are experiencing.