To book your pregnancy care you do NOT need to visit your GP for a referral

Please complete the form below to book your antenatal care and delivery with Darent Valley Hospital. After you submit this form a notice will appear on your screen confirming it has been submitted.  You will also recieve a copy of your completed form to the email address you have provided.

Your maternity appointments will be sent to you via email, unless you choose not to use this option. If you have not chosen to receive your appointment via email, it will arrive via post. We aim to provide you with the earliest available appointment in your area and provide a scan date from between 12 weeks to 13 weeks and 6 days of pregnancy.

You can complete the online self referral form below or print off a word version send it to us via the Community Midwives Office, c/o Delivery Suite, Darent Valley Hospital, Darenth Wood Road, Dartford, Kent  DA2 8DA. 

Please note that postal communication may delay you receiving appointments. 

Pregnancy Self Referral Form

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Ethnic Group

Please provide your ethnic group, this is extremely important information that will help us with your care during pregnancy.

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Special Requirement

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GP Details

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Your Clinical Details

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Regarding any previous pregnancies, how many of the following have you had?

Regarding previous births, how MANY times and WHERE have you delivered?

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