Book of Remembrance
Together we care and remember. The loss of your baby during any stage of pregnancy, birth or very early life is a deeply sad and upsetting time. We are sorry for your loss. We have a remembrance book where you can choose to make a personal entry for your baby. The book is cared for and displayed in the hospital chapel. The page will be opened on your baby's anniversary each year.
About You:
Title
*
Please Select
Miss
Sir
Mr.
Ms.
Mrs.
Dr.
Prof.
Mx.
First Name
*
Last Name
*
Email
*
Mobile Number
*
Please enter a valid phone number.
Format: 07000 000 000.
Date of birth
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Address:
House Name or Number
*
Street Name
City
County
Postal Code
*
Country
House Number + Street Name
Back
Next
About Your Baby:
Your baby's name:
*
Date of birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date of death
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Short inscription
*
Would you like to make a donation to Birmingham Women's Hospital Charity?
Yes
No
Submit
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