Request a Photographer

Request a Photographer

This form is only for requesting the attendance of a photographer. Our service is available for babies of 20 weeks gestation and upwards, - sadly we do not have the capacity to provide a service outside of this. If you have a general enquiry, or wish to cancel an existing booking, please call us on 0808 189 2345. Please also ensure that the full name and address including the postcode of the hospital, hospice or funeral home, is completed below, as unfortunately, without this section being completed in full, we won't be able to process your request. Thank you.
Are you:*

A member of staff contacting us from a hospitalA member of staff contacting us from a hospiceA member of staff contacting us from a funeral homeContacting us directly (parent/family member/friend etc.)
About you

We need to collect a few details so that we can contact you
Your Name*

First NameLast Name
Date of request*

DayMonthYear
Date
Important information required

Please ensure that the full name and address including the postcode of the hospital, hospice or funeral home, is completed in the section below, as unfortunately, without this section being fully completed, we won't be able to process your request. Thank you.
Name and address of the hospital, hospice or funeral home*

Name of Hospital

Address

CityCounty

Postcode
Please let us know your connection with the mother and baby*
Your email address*
example@example.com
Your phone number*

Area CodePhone Number
Extension number (if appropriate)
Are you the best person for us to call back with regards to this request?*

YesNo
If not, who should we call?
Name of person that you would like us to contact
Their telephone number

Area CodePhone Number
Extension number (if appropriate)
About mother and baby

We need to collect these details to register the request. Data is stored in line with our Privacy Policy, which can be found on our website at www.remembermybaby.org.uk
Mother's name*

First NameLast Name
Partner's name (if appropriate)*

First NameLast Name
Baby's name - If the baby hasn't yet been named, please put N/A*
Baby's date of birth*

DayMonthYear
Date
Sex of baby*

MaleFemale
Is the baby alive?*

YesNoBaby is not born yet
We can only usually arrange an appointment once baby has been born.

If baby's arrival is scheduled for a time in the future, or the mother is currently in labour, please complete a new request when baby has been born.

If you need advice, please call our freephone number 0808 189 2345 instead of completing this request.
Baby's gestation at birth - Please note that we are currently unable to provide a photographer for babies born earlier than 20 weeks.*
Gestation when baby was born
Baby's age now (days/weeks/months)*
Where in the hospital/hospice is baby located?*
Further information to help us

We need some more information to help us allocate an appropriate photographer for you.
Baby's visual condition*
It is important that you mention anything relevant to us such as skin slippage, discolouration, and any medical conditions affecting appearance or the ability to move baby. This is so that we can assign experienced photographers to more complex cases.
Was this a multiple birth?*

YesNo
Please tell us briefly about the other baby/babies. Are they still alive, in NICU etc, and do family want this baby included too?*
Do parents want to be involved with the photos?*

YesNoUnsure
Are there any siblings or other family members that would like to be involved?*

YesNoUnsure
Who should we email the Consent Form to?*

MyselfA colleague
Email address for Consent Form
example@example.com
What time is shift change?*
Should be Empty:

Request a Photographer

About you

Important information required

About mother and baby

Further information to help us