The Physiological Measurement Leadership Group have as an adjunct to the Guidelines and Standards for common peripheral Neurophysiological procedures devised a Referral Questionnaire to help referring doctors and departments where Clinical Physiologists run extended role clinics.
The questionnaire helps to select patients suitable for screening for a) Carpal Tunnel Syndrome b) Ulnar nerve entrapment neuropathy at the elbow and c) Suspected generalised axonal peripheral neuropathy. In all cases these clinics are not for a differential diagnosis but to confirm a strong clinical impression of one of these three diagnoses.

There are a number of questions which when answered positively identify patients who would more suitably be seen by a Consultant Clincial Neurophysiologist. The particular questions which are felt to be exclusive are left to the clinical judgement of the professional who carries responsibility for the clinic.

To see a *.pdf file of the questionnaire which you can print, please click here.