Prenatal Breastfeeding Education 
Prenatal classes are offered in a group setting via Zoom. This is covered by most insurances, but some families choose to pay out of pocket to save their lactation visits for when the baby is born. The class is $75 if paid out of pocket and due before the class. 
Sign in to Google to save your progress. Learn more
Email *
Email *
First and Last Name  *
Date of Birth
MM
/
DD
/
YYYY
Zip Code  *
Phone Number  *
Estimated Due Date? *
MM
/
DD
/
YYYY
What class would you like to attend? *
Insurance Coverage  *
Do you plan to have this covered by your insurance?  *
Do you need help ordering your breast pump from your insurance company?  *
Any additional comments or concerns
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy