Antenatal self-referral form
Use this online form to self-refer to maternity services at Queen Charlotte's & Chelsea and St Mary's hospitals. It is important to start your antenatal care early in your pregnancy, as soon as you find out you are pregnant.
Congratulations on your pregnancy and thank you for choosing to have your maternity care at Imperial College Healthcare NHS Trust. We provide maternity care at two hospital sites – St Mary’s Hospital and Queen Charlotte’s & Chelsea Hospital. We also offer care in the community, which includes home births.
Please provide as many details as possible when completing this form. This will help us ensure you see the right team for you as soon as possible. We will let your GP know that you have booked your maternity care with us.
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