Western Road Medical Centre

99 Western Road, Romford, Essex, RM1 3LS

It's Sunday 3:46 AM — Sorry, we're closed

Telephone: 01708 775300

Fax: 01708 737936

Antenatal Care Plan

Weeks of Pregnancy		Venue	Who	Reason

As soon as pregnancy seems likely		Western Road Medical Centre	GP	Arrange hospital booking 0208 970 5757 Remind Folic Acid until 13th week
11 to 13	All	Queen’s Hospital		Book with consultant Ultrasound, Blood tests, Nuchal Translucency (to look at risk of Down’s Syndrome)

23	All	Queen’s Hospital		Detailed Ultrasound scan to ensure baby is developing normally

25	1st time mothers only	St Kilda’s Clinic	Midwife	Blood Pressure and to discuss any concerns

28	All	St Kilda’s Clinic OR Hospital	Midwife	BP, Urine test, Examine Abdomen, Blood test (form in brown envelope in red book
28	All	St Kilda’s Clinic OR Hospital	Midwife

31	1st time mothers only	St Kilda’s Clinic	Midwife	BP, Urine test, Examine Abdomen

34	All	St Kilda’s Clinic	Midwife	Discuss Birth Plan

36	All	St Kilda’s Clinic	Midwife	BP, Urine test, Examine Abdomen

38	All	St Kilda’s Clinic	Midwife	BP, Urine test, Examine Abdomen

40	All	St Kilda’s Clinic	Midwife	BP, Urine test, Examine Abdomen

41	All	St Kilda’s Clinic	Midwife	Discuss Induction/arrange Membrane Sweep

Ante-Natal Clinic is held on Monday afternoons at the St Kilda’s Children’s Centre with the midwife
Useful Addresses
Queen’s Hospital Rom Valley Way Romford RM7 0AG Tel: 0845 130 4204 01708 435000			St Kilda’s Children’s Centre. 90 Eastern Road. Romford RM1 3QA. 01708 743135 …

Update Your Details

Order Your Prescriptions

Online Appointment Booking

Patient Participation Group

Download Practice Leaflet

Friends & Family Test

Self Care A-Z

Travel Questionnaire

Personal Details
Name
First Last
Sex
- Female
- Male
Date of Birth
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Phone Number
Email
Trip Dates
Departure
Duration (Days)
Itinerary
Country Duration (Days) Availability of Medical Help
Trip Description - please tick appropriate boxes
Purpose of Trip
- Select All
- Business
- Pleasure
- Other
Type of Trip
- Select All
- Package
- Self-Organised
- Backpacking
- Camping
- Cruise Ship
- Trekking
Accommodation
- Select All
- Hotel
- Friends/Family
- Other
Travelling
- Select All
- Alone
- Friends/Family
- In a group
Location Type
- Select All
- Urban
- Rural
- Altitude
Activity Type
- Select All
- Safari
- Adventure
- Other
Personal Medical History
List all chronic medical conditions that you have (eg. diabetes, heart or lung conditions)
List all allergies that you have (eg. eggs, nuts, antibiotics)
If you have had a serious reaction to a vaccine in the past, which vaccine was it?
List all of your current medications (including oral contraception)
- Select All
- Have you recently suffered from any infection (e.g heavy cold, flu or high temperature)?
- Does having an injection cause you to feel faint?
- Do you or any close family members have epilepsy?
- Do you have any history of mental illness including depression or anxiety?
- Have you recently undergone radiotherapy, chemotherapy or steroid treatment?
- Have you taken out travel insurance?
- If you have a medical condition, have you told your insurance company about it?
- Are you pregnant, planning pregnancy or breast feeding?
Write below any further information that might be relevant
Vaccination History
Have you ever had any of the following vaccinations / tablets and if so, when?
- Select All
- Tetanus
- Diphtheria
- Hepatitis A
- Meningitis
- Influenza
- Jap B Enceph
- Malaria Tablets
- Polio
- Typhoid
- Hepatitis B
- Yellow Fever
- Rabies
- Tick Borne
- Other
If other please state

Opening Times

Monday
Open (Basic queries only): 08.00am l Clinics start: 9:00 l Close: 6.30pm
Tuesday
Open (Basic queries only): 08.00am l Clinics start: 9:00 l Close: 6.30pm
Wednesday
Open (Basic queries only): 08.00am l Clinics start: 9:00 l Close: 6.30pm
Thursday
Open (Basic queries only): 08.00am l Clinics start: 9:00 l Close: 6.30pm
Friday
Open (Basic queries only): 08.00am l Clinics start: 9:00 l Close: 6.30pm
Saturday
CLOSED
Sunday
CLOSED

Useful Links

Country	Duration (Days)	Availability of Medical Help

Western Road Medical Centre

Antenatal Care Plan

Update Your Details

Patient Participation Group

Friends & Family Test

Travel Questionnaire

Personal Details

Trip Dates

Itinerary

Trip Description - please tick appropriate boxes

Personal Medical History

Vaccination History

Opening Times

Useful Links