Please ensure the expectant parent is aware that you are making this referral. To reduce re-traumatization please tick unknown if you do not already know the answer to any question.

If you wish to discuss the referral prior to submitting, please contact 0141 471 9799 or email

Referrer information

Parent details

Are they:

More Information

If you would like to discuss this referral, please call 0141 471 9799 or email

Information that you pass on to us will be treated in the strictest confidence. Anything disclosed to us will not be passed on to anyone outside Amma Birth Companions without the explicit consent of the person you are referring, unless there are circumstances where we believe that a person may be at risk. If that is the case, we may need to speak to the relevant professionals. We will share information within our team on a need-to-know basis.