Breastmilk Donation for Dr.Kristian
After a serious car accident Dr.Kristian is not able to feed her 3-month old baby. Please fill out this form if you currently live in the DMV area and have unexpired breastmilk to donate to baby August. The information that you give in this form will ONLY be used to contact you in order to pick up milk donations. You can also help the family by donating using the PayPal link below:

https://www.paypal.me/brotherspanky

Dr.Kristian is also the creator of @blkandgrn, because of her amazing team the online store is still up and running, purchases made at this time will be able to support the family thru this time.

Name *
Your answer
Location *
Your answer
How much milk can you donate? (in ounces) *
Your answer
Do you have any health conditions, complications etc that may or may not impact the breastmilk you are donating? *
Required
If yes please describe the condition. *
Your answer
Phone number *
Your answer
Current address *
Your answer
What time are you available for someone to pick up the milk from your home? (Close friends of Kristian are driving around to pick up all donations.) *
8 AM
9 AM
10 AM
11 AM
12 noon
1PM
2 PM
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
monday
tuesday
Wednesday
thursday
friday
Saturday
sunday
Race (the family just would like to know for personal reasons but all milk is being accepted regardless of race.) *
I agree that all the information in this form is factual and true. I understand that I am donating breastmilk to Dr.Kristian to be used for her baby (August). I agree that I have no health issues that will impact the milk I am donating, and if I do I have stated those complications above. By typing your full name you are agreeing to these terms. *
Your answer
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