Request Lactation Consultation

Call us to schedule or fill out the form below to request a single consultation (in-home or online). Take advantage of our package deal by ordering 3 consultations and getting 5% off!

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in

Please note that all fields followed by an asterisk must be filled in.
First Name*

Last Name*

E-Mail Address*

Street Address*

City*

State/Prov*

Zip/Postal Code*

Phone #*

In-home or Online?

Single or Package?

Please enter the word that you see below.