Request an Appointment with a Midwife

Patients do not need to attend the surgery on discovering they are pregnant, though they are welcome to. Patients can self refer to Epsom Hospital, St Helier Hospital or Kingston Hospitals using the forms below:

If you are already under one of the hospital teams and would like an appointment with the midwife based at the surgery, then please complete our form.

Request an Appointment with a Midwife

Request an Appointment with a Midwife

Section

Have you already self-referred to a hospital? *
Please use date format DD/MM/YYYY
Would you like to self refer now? *

You should self-refer to whichever hospital you want to have the baby when you discover you are pregnant. You do not need to see the GP unless you have any medical concerns.

Visit the relevant hospital website to find the self-referral form and further information: