Baby Photo Request

Your name

Your baby’s full name, including surname

Child's date of birth

Time of birth

Weight
Pounds 12 11 10 9 8 7 6 5 4 3 2 1 Ounces 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0

Weight (Grams)

Eye colour
Blue
Dark Blue
Brown
Hazel
Green
Gray
Other

Hair colour
Brown
Dark Brown
Light Brown
Black
Dark Blonde
Blonde
Red
Aubyn
Other

Child of (parents' names)

Your email

THE FOLLOWING WILL NOT APPEAR ON THE WEBSITE:

Relationship to baby
Mother
Father

Sex of baby
Male
Female

Your Room Number

Phone Number

I do not wish to have this birth notice published on social media (such as Facebook, Instagram etc)

Upload photo below or leave blank if you want the photographer to take a photo:

PLEASE READ THE FOLLOWING AND TICK THE CHECK BOX:
The information made available or through the Taranaki District Health Board (TDHB) Website (Birth Notices pages) and TDHB Facebook page, which includes the photograph of your baby, is intended to provide information to the public regarding the birth of your child following your written consent. TDHB has taken all reasonable means to ensure the quality and accuracy of that information. Given the TDHB website is accessible by the general public, TDHB is not responsible for the security of the information (which includes the photograph of your baby) displayed on the TDHB website. TDHB is not responsible for the content of other websites or organisations which choose to access this information. TDHB neither endorses the information, content, presentation, or accuracy of such other websites nor makes any warranty, express or implied regarding these other websites.

I have read and agree with the terms and conditions above (Required)