Maternity Exemption Certificate
Please use this form if you are requesting for a certificate for maternity exemption certificate. entitles a woman to free prescriptions and dental care. It is issued at any point during pregnancy
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A maternity exemption certificate entitles you for:
- free NHS dental treatment
- free NHS prescriptions, if you have a valid maternity exemption certificate
When it expires
Your certificate will expire 12 months after either:
- your due date
- the birth of your baby
Entitles a woman to free prescriptions and dental care. It is issued at any point during pregnancy
Please include your latest personal details so that we can contact you if necessary
Your Full Name
Your Date of Birth
Please include your DOB in the form of DD/MM/YYYY i.e 01/01/1980
Your MOBILE number
If we need to contact you to clarify your answers especially if your asthma is poorly controlled
Your EMAIL address
MATERNITY EXEMPTION CERTIFICATE REQUEST
Are you pregnant?
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This form was created inside of west green surgery.