Breastfeeding Friendly Business Designation Application

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Please fill out the entire survey to verify your business is "Breastfeeding Friendly", to receive your designation. Designation includes certificate and window decal to display, as well as listing on our website.

Email *

Business Name

Contact Person & Title

Contact Phone Number

Business Address

Business Website

Describe how your employees have been informed of the California state law regarding breastfeeding in public places (CA Civil Code Section 43.3) and trained in how to serve customers who are nursing their babies while visiting your establishment.

Does your business have a written policy regarding lactation accommodation (meeting minimum requirements of CA Labor Code Chapter 3.8 Sections 1030-1034) for employees who are breastfeeding or pumping while at work?

Yes - email copy to placerbreastfeeding@gmail.com - we consent to allowing our policy to be posted on the Placer County Breastfeeding Coalition website as a model for other businesses

Yes - email copy to placerbreastfeeding@gmail.com - please do not post our policy on the website

No - We would like a representative to contact us to help us develop a written policy

Clear selection

Once designated, how many "Breastfeeding Friendly Business" decals would your business like to display. Great for windows, front doors, and check-out registers!

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