Self-Registration Form for Maternity Care

Please complete all mandatory fields marked with *.  Failure to do so may slow down the processing of your registration.  Please share with us any information that you think is relevant to providing care for yourself or your baby.  The answers you provide will allow us to pass your registration to the correct Midwifery or Obstetric Team; therefore it is essential that you share as much information as possible.

Registrations can also be made by calling your local community midwives’ office on (Aylesbury) 01296 316120 or (High Wycombe) 01494 425172.

Please send all completed Self-Registration forms to bht.maternityreferrals@nhs.net – Thank You.