This form enables you to book yourself into Worthing Hospital or St Richard's Hospital, Chichester for the birth of your child.
Please click on the following link for information on vitamins recommended in pregnancy: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vitamins-minerals-supplements-pregnant.aspx#close For Screening information for you and your baby: http://www.screening.nhs.uk/getdata.php?id=7885 To work out your BMI, which is a required for this form, please click on the following link: http://www.nhs.uk/tools/pages/healthyweightcalculator.aspx Please take the time to read the information booklet about scans and screening tests, please click on the following link: https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-description-in-brief
Please complete the form below and click Submit, if you encounter any difficulties completing this form please call telephone triage on 01903285269.
The information you enter into this form will be used to prepare for your visit for the birth of your child. Everyone working with the Trust must keep your information confidential and secure and share it only when necessary to provide you with the proper care during your stay. The fields marked * are compulsory but it is recommended that you complete as many optional fields as you can so that we have enough information to contact you in the case of a cancellation. By completing these optional fields you consent to us contacting you via this method. For example, by entering a phone number you consent to us contacting you by telephone. In this case you should bear in mind that someone other than yourself may answer the phone.
A copy of this form will be sent to your GP to notify them that you are planning on having your baby at the selected hospital
If you wish to clear the form of any data entered, click Reset.