Just found out you're pregnant?

Here's what to do next...

Self-referral service for Lancashire Teaching Hospitals ( Includes Royal Preston Hospital and Chorley and South Ribble Hospital)

As soon as you find out you are pregnant you have the option to book your maternity care directly with Lancashire teaching Hospitals instead of seeing your GP; we encourage you to do this as soon as possible so you can see your midwife and have your early screening tests.

Note: Questions marked by * are mandatory

Please answer the questions as fully as possible as this will enable us to ensure you receive the most appropriate care.

When you submit the form our booking team will arrange your first booking appointment and also notify your GP of your pregnancy. Your first booking appointment will be sent to you via the email address you provide.

It is now routine practice for women to be seen on their own for the first 10 minutes of their appointment

If you do not receive an appointment within three weeks then please call us on 01772 524726

Folic acid

It is recommended that you start taking Folic acid (0.4mg) supplements as early in pregnancy as possible. These tablets are widely available in pharmacies and supermarkets. Folic acid is important for the development of your baby’s nervous system

Self referral form

Note: Questions marked by * are mandatory

Birth Location Preference

About You

  Yes No
Are you a smoker?
The risks of smoking during pregnancy are serious. To give your baby the best start in life we will refer you for support in stopping. Respond “No” if you do not agree for your details to be shared with the QuitSquad?

GP Surgery Details
Current Pregnancy Information
Previous Pregnancy Information

  Yes No
Were any of your children born before 34 weeks gestation?
Have you had any miscarriages?
If yes, have you have experienced 3 or more miscarriages in a row?
Medical History
  Yes No
Do you have diabetes?
Do you have epilepsy?
Do you have mental health problems?
Have you experienced a blood clot in your leg or lungs e.g. DVT
Have you experienced ectopic pregnancy
Do you have Renal (kidney) disease?
Do you have a respiratory (breathing) disease such as severe asthma?
Do you have heart disease?
Do you have a blood disorder?
Do you have an auto-immune disease?
Do you have high blood pressure?