Self Referral Form

Women can now self refer to the BHSCT Maternity Service in Mater Midwifery-led Unit or Royal-Jubilee Maternity Hospital (Midwifery-led care or Consultant-led care) as soon as they have a positive pregnancy test.  By completing the self referral form via the hyperlink below:

Click to open Self Referral Form

The form can be completed either on line and forwarded via email or alternatively printed and completed manually.
Upon receipt, the midwifery team will arrange the first booking appointment for you, and also notify your GP of your pregnancy.

Our aim is to ensure you receive maternity care in the right place, with the right people looking after you and your baby and would advise you to read the 'Now you are pregnant' leaflet for Birth place choices, click here. We would be delighted if you choose to attend the Royal Jubilee or the Mater (if your pregnancy is straightforward) for your care.

Please return completed form:

By Email:
By Post:  Maternity Appointments
                C/O Medical Records
                1st Floor
                Royal Jubilee Maternity
                Grosvenor Road
                Belfast BT12 2BA