You are in:
Home/ Find a service/ Maternity Services/ Self-referral forms/ Self-referral form - Castle Team

Self-referral form - Castle Team

Thank you for choosing to have your baby at Medway. You now have two options. You can arrange your booking appointment by phone or by using our online self referral form below.

If you need help completing the form or need an interpreter, please contact us.

Online self referral

Will you require an interpreter?

In order to complete our antenatal and postnatal screening programmes, could you please confirm the following for yourself, your partner and both sets of parents:

Have you had a baby before? *
Have you had a baby before delivered via caesarean section*
Would you consider having a home birth?*
Would you like more information about home birth?*
Do you have either Type 1 of Type 2 diabetes*
If yes, are you Type 1 or Type 2?
Are you or your family receiving any support from the following professionals? (tick all that applies)
Do you smoke?*

You are four times more likely to quit smoking if you have support from The Stop Smoking Service. They have specialist pregnancy advisers who can offer individual support and FREE Nicotine Replacement Therapy.

Medway Maternity PHR

Medway NHS Foundation Trust have now launched a digital maternity personal health record (PHR) that allows you real time access to your maternity records through your smartphone, PC or tablet device instead of issuing paper maternity notes. The service is opt-in and can be enabled at any time. The information that appears is generated in real time from our hospital maternity system, using details entered by all healthcare professionals involved in your care.

Information available

You will be able to see a summary of your pregnancy details including

  • Booking summary
  • Antenatal appointments with the midwife or doctor
  • Antenatal admissions summary for each attendance
  • Labour and birth summary
  • Postnatal care and appointments
  • Summary of baby’s care 

You will not be able to see any sensitive information via the PHR including domestic violence disclosures/social concerns, HIV status or confidential previous pregnancies. 

Data Security

All your information is held securely and Medway’s PHR uses the same secure platform used by the healthcare professionals involved directly in your care. Access is authorised after we receive your online referral and validation of your email address. These allow us to set up secure verification, which is important because it ensures your personal maternity records can only be accessed by you. Your email address will only be used by the hospital to contact you regarding your pregnancy; it will not be shared with any other external organisations. For further advice on keeping your electronic records safe, please click on the link below:

http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Documents/PatientGuidanceBooklet.pdf

Check your email

If you consent to use the PHR please check your email regularly, as this is how we will send you details of your first appointment with a midwife and provide access to your pregnancy booking documentation. You may need to check your junk email folder.  The email we send you will also include links of how to login to the PHR. We encourage you to enter as much of your personal information into the PHR as required prior your booking appointment. 

Please note it can take up to 5 days for your referral to be logged and actioned.