Forms for completion

Pregnancy Form

Please complete this form before your first initial appointment with the midwife and submit this back to us via the email at the bottom of the page

St Marys Pregnancy Form

Smoking Status

In order to help and support our patients, it is important that we have some up to date health information. Accordingly, please complete and submit the smoking status questionnaire to us using the link:

Smoking Status Questionnaire

7 Day home blood pressure monitoring

Please complete the attached form and return this to the below email address if requested to by a clinician at the surgery

7 Day Home Blood Pressure Monitoring

Travel Questionnaire 

Please complete the travel questionnaire and contact the surgery to arrange an appointment with our travel nurse

Travel Questionnaire

Online Access to medical records 

If you wish to access your medical records online please complete the form and return this to the email address found below. 

Online Access to Medical Records

Please submit all of the above forms via email to

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