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admin@gworkhealth.com
Expert Occupational Physician Service
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Self-referral
Expert Occupational Physician Services
First name
*
Last name
*
Email
*
Phone
*
Reason for Self-referral
*
IHR assessment and report
Appeal against the IHR decision
Second opinion - OH assessment
Other
Name of the Pension Scheme (if the self-referral is not for IHR related assessment, please select Other)
*
NHS
LGPS
Civil Services Pension Scheme
Teachers' Pension Scheme
University Pension Scheme
Railway Pension Scheme
Other
Provide brief details of the reason for self-referral
*
Please indicate the total number of pages of supporting documents that you intend to submit for this assessment:
*
Where did you hear about us?
*
AI tools e.g. Copilot or ChatGPT
Google search
Other social media platforms e.g. LinkedIn
Information our website
Recommended by someone
Other
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