In accordance with the latest amendments to the Information Privacy Act, RBWH Foundation will contact any Royal Mum newly registered by someone other than themselves in order to gain their direct permission to have their name included on the Royal Mums Online Honour Wall and the Honour Wall displayed at the hospital. Once this approval has been received, the Royal Mum will be immediately published on the Online Honour Wall and included in the next update of the hospital Honour Wall
Surname to Appear on Honour Wall (if different from above):
Royal Mums Date of Birth (for security checks only) DD/MM/YYYY:*
Street Address or PO Box:*
What is your relationship to this Royal Mum?:*---SelfHusbandMotherMother-in-LawFatherFather-in-LawDaughterDaughter-in-LawSonSon-in-LawGranddaughterGrandsonAuntUncleNieceNephewCousinFriendOther
Is this Royal Mum deceased?:*---YesNo
How many babies did the Royal Mum have at the Royal Brisbane & Women’s Hospital?:
List the name and year of birth of each baby.
Baby 1 (First Name only):*
Date of Birth:*
Was this baby born premature?: ---YesNo
The Charity for Royal Brisbane and Women’s Hospital
Phone 07 3646 7588
Fax 07 3646 1768
Block 20, Central Drive,
Royal Brisbane and Women’s Hospital,
Herston, QLD, 4006.
PO Box 94
Royal Brisbane Hospital
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