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Thank you for your interest in partnering with Lactation Lab. Please complete this form and a team member will be in touch if you're a good fit. Unfortunately, at the moment we can only take on US partners. 
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Full Name *
Name of Business / Brand / Social Account *
Email address *
Social Handles and Website Name *
Which of the following best describes you? *
What product or service do you provide? (skip if not applicable)
If you are a pregnancy, birth, postpartum, and/or lactation practice, please select where you provide your services. Select all that apply. (skip if not applicable)
Tell us a little about yourself and/or your brand. *
Which US state or country do you operate in? *
Have we worked together before?
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What type of partnership are you interested in? *
If you are interested in joining the affiliate program, how would you share your affiliate codes/links and our partnership with your clients and/or online audience? Select all that apply. (skip if not applicable)
In a few sentences, tell us why you are interested in working with us. *
How did you learn about Lactation Lab? *
Which Lactation Lab product are you interested in trying? (skip if not applicable)
Please keep in mind that we are not always able to offer a product you are interested in due to shipping costs, product availability, or our changing marketing priorities.
Today's Date *
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