Self-Registration Form for Maternity Care

This form can either be printed and completed as a paper copy or edited as an electronic copy.  Please complete the form as thoroughly as you can.  Once completed an electronic copy can be sent securely to [email protected] or if you prefer it can be posted to us at:

Community Midwives,

                c/o Wycombe Birth Centre,

                Wycombe Hospital,

                Queen |Alexandra Road,

                High Wycombe, Bucks. HP11 2TT

If you chose to post your registration form please follow this up with a phone call to ensure that we have received it; our number is 01494 425172 Monday – Friday 08:30 – 16:00.

If you have any further queries, please do not hesitate to contact the Community Midwives Office using the telephone number above.