Lisa Boyd - Lactation Consultant IBCLC

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LisaMBoyd70@gmail.com

805-235-5790 (text please, voicemails get missed!)

Lactation Services provided in the comfort of your own home. I will address any issues that you have, and will provide hands on assistance, resources and referrals, education, baby's weights & assessment of milk transfer and latch, pumping, in addition to addressing any other concerns you may have. All information provided and discussed will remain confidential. I share our plan of care with your pediatrician with your permission.

Service fees: $150 for first visit in home. $100 for follow up appointments. ($25 distance travel fee applies for Orcutt or Santa Maria, $40 for Lompoc)

Unfortunately, at this time I do not take insurance, but I can provide a Superbill for you to submit to your insurance. Sliding scale for those in need, please do not hesitate to ask. ♥ Initial appointments are at least 90 minutes and if possible, schedule when your baby will be hungry enough to have a good feed.

Payment forms taken:

Cash, Check, PayPal (Lisa Boyd @SLO Doula), Venmo (@Lisa-Boyd-4), Zelle (LisaMBoyd70@gmail.com / 805-235-5790)

Please fill out what you can before our first meeting so I can be better prepared to assist you to my fullest ability during our time together.

Email *

Parent(s) Name(s): *

Parent(s) Phone Number: *

Preferred contact method *

Phone Call

Text

Required

Address: *

Baby's Name: *

Baby's Birthday: *

Baby's Birthweight: *

Brief description of birth story (Vaginal/ C-section/ Complications, etc.) *

Please check if you have / had any of the following: *

Thyroid Disorders

PCOS

Gestational Diabetes

Postpartum hemorrhage requiring blood transfusion or iron infusion

Induction of birth for medical reason

IVF or assisted birth technology

Breast Reduction/ lift

Breast implants

Breast surgeries or injuries

None

Other:

Required

Gestational age of baby at birth *

Micro-Preemie (24-28 weeks)

Preemie (29-32 weeks)

Late Preterm (33-36 weeks)

Early term 37 weeks

Term 38-41 weeks

Post-term (42 weeks +)

Did you have any breast changes during pregnancy, such as tenderness, growth, darkening of the areolas, evidence of colostrum? *

Yes

Some of these but not all

Brief description of breastfeeding experience and history: *

What are your concerns and issues that you would like help with? *

I grant permission to share the summary of our visit and our plan of care with our pediatrician. *

Yes please

No thank you

Required

Name of your Pediatrician

Whom may I thank for the referral?

How did you hear about me? :)

Send me a copy of my responses.

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