To be completed by midwife/GP. You can also use the notification of pregnancy form below if you are referring external for maternal medicine or complex pregnancies.
Please fully complete and return to the Rosie Hospital.
Please note that are all field on the form are mandatory and need to be completed in the interests of patient safety.
Please send this form to: add-tr.RosieUltrasound@nhs.net or fax to 01223 217622.
For advice/urgent referrals phone 01223 217657.