1. I give my consent for the Prenatal Breastfeeding Specialist to work with me and my baby during this consultation for my breastfeeding problem/concern. This consent is for in-person visits, as well as phone conversations.
2. I understand that a lactation consultation may involve:
3. I understand a partial or follow-up visit is sometimes necessary. I understand that breastfeeding supplies and/or breast pumps may be recommended as effective management of specific situations.
4. I understand that I am responsible for informing the Lactation Specialist of changes I feel are necessary in the care path at the time of the visit or during the course of follow-up communications. I understand it is my responsibility to call the Lactation Specialist with progress reports, questions or concerns.
5. I give my consent for Lactation Specialist to use clinical information and any photographs obtained during our sessions for conferring with other health care providers and education of mothers about lactation.