Making an appointment to see a Maternal and Child Health Nurse Home Living in Merri-bek Community services Children and families Maternal and Child Health Making an appointment to see a Maternal and Child Health Nurse On this page: Complete our online form Child's details Child's details First name Last name Date of birth (dd/mm/yyyy) Sex of child Male Female Appointment details Appointment details What is the key age visit? Home visit 2 weeks 4 weeks 8 weeks 4 months 8 months 12 months 18 months 2 years 3.5 years Other If other please detail Type of request -- Select an option -- New appointment Change to existing appointment Cancel an appointment Other If you selected other please detail Do you have a preferred day? Monday Tuesday Wednesday Thursday Friday Do you have a preferred date and time for an appointment? Have you already left a message on the Booking Line or at the Centre for an appointment? Yes No If you selected yes, please provide details Your details Your details First name Last name Date of birth Email Phone number Relationship to child Mother Father Other If you selected other, please detail New residents New residents Are you a new resident of Merri-bek? Yes No Current address Previous address Which Maternal and Child Health centre do you usually attend? -- Select an option -- Albion Street, Brunswick Glenlyon Road, Brunswick South Lygon Street, Brunswick East Victoria Street, Brunswick West Wardens Walk, Coburg The Avenue, Coburg Murray Road, Coburg Merlyn Street, Coburg North Jukes Road, Fawkner Lorne Street, Fawkner 50 Wheatsheaf Road, Glenroy Belle Vue Park, Morell Street, Glenroy Marigold Crescent, Gowanbrae Volga Street, Hadfield Prospect Street, Pascoe Vale Woodlands Avenue, Pascoe Vale South Other centre in another municipality, state or country Not sure Further information  Further information  Do you require an interpreter? Yes No If you selected yes, which language? How do you want to be contacted? -- Select an option -- Phone Email SMS Further information Submit