Maternity Bookings Form

About the form

This form helps us assess the status of your general health, medical history and your pregnancy to determine the most appropriate hospital for your antenatal care and baby’s birth.

Eastern Health provides birthing services at two sites – Angliss Hospital and Box Hill Hospital. Eastern Health will decide which hospital you attend based on your clinical needs, the hospital’s capacity to accommodate your booking and your residential address.


The Maternity Unit Online Booking form enables women to make an online request for a maternity appointment at Eastern Health and to provide their health information for the purpose of that appointment and their ongoing maternity care.

A copy of the completed form is emailed to the patient.

The completed form is used by the maternity bookings office at Eastern Health to assess the patient’s request and to make an appointment. It will also be accessed by the clinicians at Eastern Health who will be directly involved in the patient’s maternity care, to assist with the provision of that care. The completed form will be added to the patient’s medical record at Eastern Health. Information contained in the form may be disclosed to other health services involved in the patient’s maternity care, such as the patient’s GP.

If the patient does not provide accurate or complete information in the form, this may mean she does not get the most appropriate treatment, and this may have a negative effect on her health and the health of her baby (or babies).

More information about privacy at Eastern Health can be accessed on Eastern Health’s general privacy webpage.

Complete the form here