WE DON'T LEAVE THE BREAST TILL LAST
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  • Home
  • Breastfeeding
    • LC Referral Form
    • Community Lactation Clinic
  • Workforce Development
  • Peer to Peer
  • Contact
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    Breastfeeding Support

    Here at Community Birth Services we believe in a supportive and safe environment for women and whanau who are going through pregnancy, childbirth, breastfeeding and their early days of adjusting to parenthood.
    Community Birth Services is a FREE Breastfeeding and Lactation Information and Support Service that works with whanau to achieve their breastfeeding goals.
    We offer FREE Community Lactation clinics to residents of the MidCentral Region who require breastfeeding and lactation support, funded by Midcentral DHB.
    Please note: We endeavor to support all referrals however there is a triage system put into place to support breastfeeding dyads that are more vulnerable or urgent.
    Referrals can be made through our website at www.communitybirthservices.org.nz, via phone, email, through your health care provider or through our clinic.


    Appointments are limited.
    CBS Lactation Consultancy Service Referral Form (MidCentral Region)
    Please complete this referral form if you are a mum that needs breastfeeding support or you are referring a client that needs breastfeeding support

    Referral information

    Referred details

    If there is a history of baby's weight you would like us to know, please indicate that here.

    Other information

    If there is anything else you would like us to know that we haven't asked please let us know here

    Consent to share

     Please indicate below if you consent to us sharing your breastfeeding and lactation care plan with your lead health care provider 
    Please tick where you provide consent
    Please complete if known
    Please complete if known
    Please complete if known

    Covid 19 screening/declaration

    Authorisation

    I agree to the information on this form being collected and used by Community Birth Services for reporting purposes only.  Names will not be disclosed or passed on to any other organisations or people without the permission of the client named in the referral form giving their consent.
    PLEASE READ CAREFULLY BEFORE YOU SUBMIT THIS FORM.  If you have completed this form correctly, when you press 'SUBMIT' you will receive a confirmation message on your screen.  Please note you will not be sent a confirmation email.  The form will not submit and you will not receive a confirmation on your screen if the mandatory information has not been completed, so please check the form again and submit. 

    If you have not heard from a member of our team, please call us on 022 528 2466 so we can action your referral as quickly as possible.
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022 LATCHON - 022 528 2466
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