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Self Referral Form for Antenatal Care

Congratulations on your pregnancy! Thank you for choosing Macclesfield District General Hospital for your care.

Once you have submitted this form, you will receive a call back to arrange your booking appointment and discuss early pregnancy advice and information with you. The call back service operates Monday - Friday, 9:00 - 16:30.

Should you prefer to speak to us please call 01625 661163 (Monday - Friday | 9.00am - 4.30pm).

If you have any non-urgent queries regarding your pregnancy and keeping well in pregnancy, you can find information available at https://www.nhs.uk/pregnancy/.

It is advised that all pregnant women take folic acid 400mcg and vitamin D 10mcg daily, these are available to purchase at various retail outlets. If your BMI is above 30, you are diabetic or you have a family history of any neural tube problems (such as spina bifida), you should see your GP to obtain a prescription for higher dose folic acid.

Screening tests will be offered to you during your pregnancy, as well as when your baby arrives. There is information available for these tests at https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby.

Self Referral Form

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Address
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Baby’s father details

Address (if different to your own)

Current partner details (if not baby's father)

Address (if different to your own)
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