Congratulations on your pregnancy! 

You can refer yourself to our Maternity service if you are registered with a GP practice in Blackpool, Fylde or Wyre using the form below. Please contact your local GP if you are registered elsewhere.

Date of birth Required
Your address Required
May we contact you by email?
Phone type
Can we leave a voice message?
Can we send you text messages?
What is your ethnic origin?
Do you require an interpreter?
What was the date of your last period?
Are you a smoker?
Do you have a disability? Required
Do you have any medical conditions? Required