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Maternity unit
Pregnancy
Giving birth
Infant care

Online Preregistration

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Online pre-registration

bébé Home Page

Pre-register at the Maternity

Online Preregistration

My personal information

Birth name (maiden name)

Usual name (wife name)

First Name

Date of birth

Nationality

My contact details

Address

Zip Code

City

Country

Phone number

Email

Communication method preference

By email

By phone

My pregnancy information

Are you covered by the French national health insurance ?

Yes

No

Name of your complimentary health insurance provider if applicable

Name of your health insurance provider if applicable

Do you benefit from a special scheme of the French National Health Insurance?

Yes

No

What is the name of the special scheme?

Estimated due date of childbirth

Is this your first pregnancy ?

Yes

No

Have you ever had a caesarean section ?

Yes

No

Do you expect twins ?

Yes

No

Your choice for childbirth?

In an environment where your comfort and safety will be assured in the event of an unforeseen complication, we can accompany you as you wish :

For a delivery with the Midwives of our team with the intervention of the on-call Ob-Gyn in the event of a complication

For a delivery with the on-call Ob-Gyn

A bespoke delivery with the Ob-Gyn you have chosen. Pregnancy medical follow-up will then be provided by the Ob-Gyn you have chosen for your delivery

For a caesarean section for medcal reasons

For a caesarean section on maternal reques

Name of the chosen gynecologist, if applicable :

Would you like a cost estimate for an epidural anesthesia ?

Yes

No

In case of a caesarean, you wish to be accompanied by

The Ob-Gyn you have chosen (pregnancy medical follow-up and delivery with the same Ob-Gyn

The on-call Ob-Gyn

Your request

By sending this form, I agree that my information will be used by the American Hospital of Paris to respond to my request. My data is processed in accordance with the Privacy Policy. In accordance with the modified data protection act of January 6, 1978, I can exercise the rights of access, rectification, deletion and portability on my data by writing to dpo@ahparis.org with proof of identity.

Une question ? Contacter Caroline Fontanier, Patient manager

+33(0)1 46 41 83 73

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Contact

American Hospial of Paris

63 Boulevard Victor Hugo

92200 Neuilly-sur-Seine

Tél. +33 (0)1 46 41 25 25

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Accredited by the American Joint Commission

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