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 receive 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

Required
Required
Required
Required
Required
Required
Required
Required
Required
Required
Required

Ethnic Group

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

Required
Required

Special Requirement

Required
Required
Required
Required

GP Details

If you do not have a GP please write NOT REGISTERED

Required
Required
Required

Please note you may receive a telephone call regarding any questions related to your referral, the call will be from a withheld number or private caller.
 

Terms and Conditions - on-line forms These terms and conditions apply solely for this website: https://www.dgt.nhs.uk/
Dartford & Gravesham NHS Trust provides its service to you, subject to the following terms and conditions for use, which may be updated by the Trust from time to time without notice to you. By using this site you agree to the terms and conditions. Any information submitted through forms on this website are transferred to us by e-mail, will be dealt with by us in accordance with data protection legislation. E-mails are not encrypted before being sent to us and, as the Internet is not always totally secure, users are sending the information at their own risk.