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Self-referral form

Please complete the form below with as much detail as possible, as this will enable us to process your referral more quickly. Your referral will then be processed, and you will be contacted by a community midwife to arrange a booking appointment in week ten or eleven of your pregnancy. We will also advise your GP that you are pregnant, as we are obliged to them know we are caring for you. Please allow up to ten working days for us to process your booking, however, if you have any queries please contact the Antenatal clinic on 01202 442327.
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You will be contacted by email with details of your appointments
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History
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Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, Dorset BH15 2JB. Tel: 01202 665511

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