Functional Electrical Stimulation (FES) for Foot Drop of Central Neurological Origin for Patients under 16 years application form

msword File
Functional Electrical Stimulation (FES) for Foot Drop of Central Neurological Origin for Patients under 16 years application form
Filename: FUNTIONAL-ELECTRICAL-STIMULATION-PA-FORM.DOC
File type: DOC
File size: 93 KB

Please complete this form for all patients requiring this intervention. If the patient clearly meets the criteria, please submit an application to the RSS team either at bnssg.referral.service@nhs.net or using the e-RS system including all relevant referral documents and await confirmation of funding before making a referral.