Ask The Certified Lactation Counselor (CLC)
Please complete this form to get your breastfeeding questions answered or to schedule a visit with a CLC. In order for us to meet your needs with the highest standard, we ask for a nominal donation for in person assistance. The suggested amounts are $25, $45, $65 or $85 (Donations are not applied for Brilliant Detroit participants)
What is your zipcode?
Are you a Brilliant Detroit Participant?
First and Last Name?
What is your phone number?
Never submit passwords through Google Forms.
This form was created inside of Your goodVillage Collective.