Maternity contact form — Wellington, Hutt and Kapiti

Fill out this form if you live in Wellington, Hutt and Kapiti and need help finding a midwife.

If you live in Wellington, Porirua or Kapiti, you can also call us on 0800 346 369 (0800 Find MW).

If you live in Hutt Valley, you can also call us on 0800 488 628 (0800 HUT MAT).

Fields with an asterisk (*) are required.

First name

Last name

Date of birth

Phone number

Email address

Your address

National Health Index (NHI) number, if known

Ethnicity

Additional details

What date did your last period start?

How many weeks pregnant are you?

When is your pēpi's estimated due date of birth?

How many times have you been pregnant (including this pregnancy)?

How many children have you had?

Do you have any health history, medical conditions or disability that you would like us to know about?