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New University Hospital
pregnant

Pregnancy monitoring

Appointment request

To request a pregnancy follow-up appointment, please fill out the form below.

You can also contact us at 02 31 27 25 25 if you prefer . For appointment requests unrelated to pregnancy, please send us an email.

Maternity and Obstetrics Department
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Pregnancy monitoring
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  • Identity and contact details

    Ex: 06 12 34 56 78 or +33 6 12 34 56 78
    Example: firstname.lastname@example.fr
    Please carefully enter your phone number and email address, as they will be used to contact you.

  • Healthcare professionals involved in your care

  • Current pregnancy

    Pregnancy monitoring is organized with a consultation every month and 3 mandatory ultrasounds.

    If a first-trimester ultrasound has already been performed
    Reference information if you have not yet had an ultrasound
    Is this a multiple pregnancy (twins, triplets...)?
    Is this your first pregnancy?
    Only for end-of-pregnancy appointment requests

  • Your background

    Before pregnancy

    Health problem requiring regular medical follow-up?

    If this is not your first pregnancy

    During your previous pregnancy(ies), did you ever have a cervical cerclage?

    Due to the University nature of the Hospital Centre, the presence of a student during consultations is possible.

    Only one accompanying adult is allowed for consultations and ultrasounds. The presence of children is not permitted.

    If you do not speak French, please come accompanied, if possible, by someone who can translate.

    Upon receipt of this form, we will contact you by phone or email as soon as possible.

  • Summary before sending

    Check your information. Use “Edit” to correct it before submitting.