Midwife referral

In order for us to refer you to a midwife, we require some information from you. Therefore, please fill out the contact form below as completely as possible. We will then forward your details to the relevant midwife.

If you have found a midwife yourself, please notify us promptly!

Please note that we only refer midwives in the city of Würzburg and the district of Würzburg.

By completing the form, you grant us permission to share your data with the midwife. If the midwife is available to assist you, either we or the midwife will contact you to discuss the. further procedure. Unfortunately, we cannot guarantee that we can refer a midwife, but we will help you find a suitable solution, like, for example, on-call service.

Persönliche Daten

Last name

First name

Telephone 1

Telephone 2

Postcode

City

Street, house number

Expected date of birth

How many pregnancies have you had, including this one?

Are you expecting a multiple birth?

Yes

In case of changes, e.g. marriage / relocation

Last name (NEW)

First name

Telephone (NEW)

Postcode (NEW)

City

Street, house number (NEW)

Services required

Please provide only a general indication for the time being; detailed information will be discussed during a personal conversation

Antenatal care

Postpartum care

Delivery in the hospital

Delivery in a birthing centre / home birth

Preparation for birth

Reconstruction course

Your message to us

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We will get back to you by phone or email within 48 hours on weekdays