Refer yourself to our maternity services

You can refer yourself to our maternity services. 

Please tell us as soon as you find out you’re pregnant. It’s important you receive the right care early in your pregnancy.

Important information about your self-referral

You may find some questions are difficult to answer. Your answers will help us give you the right care.

You have a legal right to care during your pregnancy: find out about your rights at

We will ask for your NHS number. You can find your NHS number at

Check your details

Fill in the form as best you can.

Please check you’ve entered your correct name, date of birth, and contact details.

Giving us the right information means we can quickly talk to you about your pregnancy and care.

Help filling in this form

If you need help filling in this form you can: