Ohio Breastfeeding Services Database
Please provide the following information to be included in the Ohio Breastfeeding Online Database. It is searchable by location, so that those looking for help will see sites that are closest to them.

Be sure to provide YOUR email address (a copy of your responses will be sent to that address, and you will have to option to revise that information by following the link in that email). All other information should be for your FACILITY.

Email address
Name of person submitting information
Email address and name will NOT appear in the database, but are requested for verification purposes.
Your answer
Name of Hospital/Business/Organization
Your answer
Street address
Your answer
City
Your answer
State (use "OH" for uniformity)
Your answer
Zip Code
Your answer
Phone number (in the form "###-###-####")
Your answer
Website, Facebook, other contact information
Separate items with SEMICOLONS (";"). For best results, precede with the description "home:", "facebook:", "email:" -- for example: home: defiancecountyhealth.org; Facebook: La Leche League; email: bfrocks@gmail.com
Your answer
Services offered
Please give only a BRIEF summary; those seeking more detail should find it through your website or other contact with your facility.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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