Janet Rowan, Consultant Physician Jo Morgan, Diabetes Specialist Midwife
Referral to:
Email: jomorgan.diabetesmidwife@gmail.com (preferred)
Fax: 02825566424
URGENT concerns: 0276288125 (Jo) or 0211662988 (Janet)
Date:
Referrer's Name and Contact (include email and phone) | Woman's details Name (or Label) NHI Address Phone Mobile Circle if NO English and Interpreter essential |
Diagnosis | Early HbA1c (date) Result 75g OGTT (date) Result- Fasting 2 hour (Attach blood results please) |
Obstetric Summary EDD Gravida Para Scan results (attach please) GROW chart if generated (attach please) | Height Booking Weight BMI at booking Current weight |
Other relevant information |