Tower Hamlets lymphoedema referral

To make your Tower Hamlets lymphoedema referral please complete all the applicable fields in the form below.

Service description

The service operates Monday to Friday, 9am – 5pm and supports any patient who meets the referral criteria below.

Conditions to be meet in order for a patient to be successfully referred:

✓ The patient has at least one of the following:

  • Chronic oedema / lymphoedema

  • History of repeated cellulitis related to oedema

  • Primary lymphoedema

  • Secondary lymphoedema to cancer

✓ Systemic causes have been ruled out

Referrals will not accepted for the following:

x Known ischaemia of the affected limb

x Varicose veins

x Routine Doppler in the absence of swelling

x Venous or other ulceration

x Unstable cardiac / renal failure

x Absence of swelling

You must provide a comprehensive medical history to support assessment. It is sufficient to attach an EMIS summary.

Tower Hamlets Lymphoedema referral form