Emergency contact: +31 6 532 02 915

Register for postpartum period only

When your pregnancy is being monitored by a gynaecologist/obstetrician for medical reasons, you can sign up for guidance during the postpartum period at Vita Nova by filling out the form below. After mother and child have been dismissed from hospital, the midwife will come by your home every other day to check up on you.

  1. First Name(*)
    Ongeldige invoer
  2. Surname(*)
    Verplicht veld
  3. Date of birth(*)
    Verplicht veld
  4. Address(*)
    Verplicht veld
  5. Postcode(*)
    Verplicht veld
  6. City(*)
    Verplicht veld
  7. Email address(*)
    Ongeldige invoer
  8. Phone number(*)
    Verplicht veld
  9. Mobile phone number(*)
    Verplicht veld
  10. Name of general practitioner(*)
    Verplicht veld
  11. Insurer(*)
    Ongeldige invoer
  12. Insurance number
    Invalid Input
  13. Citizen’s service number
    Invalid Input
  14. Is this your first pregnancy? (*)

    Verplicht veld
  15. If no, please fill out the following numbers:
  16. Number of pregnancies
    Invalid Input
  17. Number of miscarriages
    Invalid Input
  18. Number of abortions
    Invalid Input
  19. Number of children
    Invalid Input
  20. When was your last child born?
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  21. Were you with Vita Nova during your last pregnancy or postpartum period?

    Verplicht veld
  22. Why are you under the care of a gynaecologist/obstetrician?
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  23. When is your due date?
    Invalid Input
  24. Are there any other details we need to take into account during the postpartum period?
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  25. Please call us twice after the childbirth: after the childbirth (at a moment that suits you) and at the moment that you’re going home, or have just arrived home. You can call us during the day at our mobile number, 06-53202915. Once we’ve received your registration, we’ll get back to you within a few days. We wish you all the best during your pregnancy and childbirth and we’ll see you afterwards!
  26. (*)
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