Congratulations on finding out you are pregnant!

Now that you have found out you are pregnant it is advised that you commence taking 400 micrograms of folic acid and 10 micrograms of Vitamin D. Some women will require a higher dose of folic acid at 5 milligrams, this can be prescribed by your GP. For further information please see: https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/

The referral form below will be sent directly to the booking admin staff. They will email you within a week under normal circumstances giving you the Date, Time and Location of your first booking appointment with the midwife. Your first appointment should be when you are around 8-10 weeks pregnant.

Please complete the form below and tell us a little about yourself and if possible, your medical history.

If you would prefer not to complete this form or are unable to do so, please contact your GP who will advise you further.

Required
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Have you ever had a different name? (e.g. changed surname after marriage).
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Address:
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I consent to receiving the following:
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Do you know the date of the first day of your last period?
Do you need an interpreter?
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GP address

Medical History

Please let us know about any relevant medical issues you may have:

Do you have diabetes?

You are entitled by law to attend any antenatal appointments and have paid time off work to attend.

Please attend the appointment provided as changing appointments may result in missed opportunities for early pregnancy screening. The first appointment is extremely important to enable you to book with your correct community team midwife and gain all the relevant information needed at the start of pregnancy. During this appointment screening will be discussed and a scan will be booked for around 12-13 weeks of the pregnancy to enable you to have the screening available within the required timeframe.