Check Elegibility – Carpal Tunnel Surgery

Describe your symptoms

How did you hear about us?

Which hand(s) are affected by your symptoms?

Right hand only Left hand only Both hands

Which symptoms do you experience? (Select all that apply)

Which fingers are affected? (Select all that apply)

How long have you been experiencing these symptoms?

Less than 3 months 3-6 months 6-12 months More than 12 months

Funding bodies typically require symptoms of >=3 months duration with documented conservative treatment trial.

Are your symptoms worse at night or do they wake you from sleep?

Yes, frequently Yes, occasionally No

Do your symptoms improve when you shake or flick your hand(s)?

Yes No Unsure

On a scale of 0-10, how would you rate your average symptom severity over the past 4 weeks? (0 = no symptoms, 10 = worst imaginable)

How significantly do your symptoms affect your ability to perform the following? (Rate each: None / Mild / Moderate / Severe)

Grip / gripping objects:

Fine motor tasks (buttons, writing):

Work / occupational duties:

Have your symptoms caused you to reduce or cease work, hobbies, or daily activities?

Yes — significantly Yes — partially No

Funding bodies generally require evidence of failed conservative management prior to surgical approval. Please answer the following carefully.

Have you used a wrist splint for your symptoms?

Yes — currently using Yes — previously used No

Splinting (particularly nocturnal) is a first-line conservative measure. Document duration and compliance.

If yes to the last question, for how long did you use the splint?

Less than 6 weeks 6-12 weeks More than 12 weeks N/A

Have you received a corticosteroid (cortisone) injection into the carpal tunnel for this condition?

Yes No

Injection response (or failure) is relevant to both diagnosis and funding justification.

If yes to previous question, did the injection provide relief?

Yes — lasting relief (>3 months) Yes — temporary relief only No relief N/A

Have you undergone physiotherapy, occupational therapy, or hand therapy for this condition?

Yes No

Have you made any workplace or activity modifications to manage your symptoms?

Yes — describe below No

Have you had a nerve conduction study (NCS) or electromyography (EMG) for this condition?

Yes No Scheduled / pending

NCS/EMG confirmation of median nerve conduction delay is required by most funders. Ensure results are attached to the referral.

If yes to the previous question, what were the findings?

Have you had an ultrasound of the wrist or carpal tunnel?

Yes No

Have you had any prior surgery to either wrist or hand?

Yes — describe below No

Do you have any of the following conditions? (Select all that apply)

These are recognised CTS risk factors and are relevant to both diagnosis and funder documentation.

Do you regularly perform repetitive hand or wrist movements at work or in your hobbies?

Yes — work-related Yes — hobby / recreational Yes — both No

Are you currently taking any blood-thinning medications (e.g. warfarin, aspirin, rivaroxaban, apixaban, clopidogrel)?

Yes — list below No

Do you have any known drug allergies or adverse reactions to anaesthetic?

Yes — list below No

Do you smoke currently?

Yes No Ex-smoker

What is your primary goal in seeking treatment for this condition?

Are you aware that carpal tunnel release is a surgical procedure performed under local anaesthetic, typically as a day procedure?

Yes No — would like more information

Do you have any concerns or questions about the procedure you would like to raise with the clinician?

Describe your symptoms

How did you hear about us?

Which hand(s) are affected by your symptoms?

Right hand only Left hand only Both hands

Which symptoms do you experience? (Select all that apply)

Which fingers are affected? (Select all that apply)

How long have you been experiencing these symptoms?

Less than 3 months 3-6 months 6-12 months More than 12 months

Funding bodies typically require symptoms of >=3 months duration with documented conservative treatment trial.

Are your symptoms worse at night or do they wake you from sleep?

Yes, frequently Yes, occasionally No

Do your symptoms improve when you shake or flick your hand(s)?

Yes No Unsure

On a scale of 0-10, how would you rate your average symptom severity over the past 4 weeks? (0 = no symptoms, 10 = worst imaginable)

How significantly do your symptoms affect your ability to perform the following? (Rate each: None / Mild / Moderate / Severe)

Grip / gripping objects:

Fine motor tasks (buttons, writing):

Work / occupational duties:

Have your symptoms caused you to reduce or cease work, hobbies, or daily activities?

Yes — significantly Yes — partially No

Funding bodies generally require evidence of failed conservative management prior to surgical approval. Please answer the following carefully.

Have you used a wrist splint for your symptoms?

Yes — currently using Yes — previously used No

Splinting (particularly nocturnal) is a first-line conservative measure. Document duration and compliance.

If yes to the last question, for how long did you use the splint?

Less than 6 weeks 6-12 weeks More than 12 weeks N/A

Have you received a corticosteroid (cortisone) injection into the carpal tunnel for this condition?

Yes No

Injection response (or failure) is relevant to both diagnosis and funding justification.

If yes to previous question, did the injection provide relief?

Yes — lasting relief (>3 months) Yes — temporary relief only No relief N/A

Have you undergone physiotherapy, occupational therapy, or hand therapy for this condition?

Yes No

Have you had a nerve conduction study (NCS) or electromyography (EMG) for this condition?

Yes No Scheduled / pending

NCS/EMG confirmation of median nerve conduction delay is required by most funders. Ensure results are attached to the referral.

If yes to the previous question, what were the findings?

Have you had an ultrasound of the wrist or carpal tunnel?

Yes No

Have you had any prior surgery to either wrist or hand?

Yes — describe below No

Check Your Elegibility

500+ procedures completed

15-minute procedure

No General Anaesthesia

Same-Day Discharge

Funded for Elegible Patientes

Check Your Elegibility

500+ procedures completed

15-minute procedure

No General Anaesthesia

Same-Day Discharge

Funded for Elegible Patientes

Don't Let Cost Stop You From Getting Relief.