Request Midwife

Booking a midwife

To check if I am available to provide your care, fill in the form below. You do not need to have seen a GP prior to booking in with a midwife. Do not be concerned if you can not answer all questions but answer as many as you can. Some information is required (marked with *). If you are returning client, (Yay!!) please click the link to this form.

Generally I will advise of availability (or unavailability) via email. I then phone you to discuss your care and history. This call will typically occur between Monday and Thursday during business hours. From there we arrange for you to see me in clinic, initially for a blood pressure check and to arrange paperwork for registration and on on-going care.

I have leave planned for February, early June and November in 2026 so will not be available for women due over those times. Other pregnancy care will be provided for while I am away.

Maternity Care Request

* Indicates required field

Name *

First

Last

Email *

Phone Number *

NHI number *

Address (please include post code) *

Residency Status *

Your own date of birth (Date/month/year) *

Your Height *

Estimated Due date (if known) *

Your pre-pregnancy weight *

Obstetric history (tick all that apply) *

Do you have any other concerns for this pregnancy or questions? *

Submit

Request Maternity Care

Booking a midwife

Maternity Care Request