Outpatient Visit Forms
We look forward to your upcoming visit to our Lactation Service. Please take online survey or print out and complete the appropriate form below. Thank you!
- For your first lactation visit:
Lactation Intake online form (preferred and takes 20-30 min) or Print Intake form (please print out and complete)
- For your return lactation visit
What to bring to your appointment
- Patient information form (see above)
- Your baby or babies
- Your breast pump
- Records of evaluation by other lactation consultants or physicians
We see mothers and infants in our outpatient clinics in both the general pediatrics and obstetrics clinics at UNC.
Ground Floor, UNC Children’s Hospital Our LCs see infants attending routine well-baby visits for general breastfeeding support. In addition, our LCs and pediatricians provide consultations for infants experiencing breastfeeding difficulties, such as difficult latch, poor weight gain, and other concerns.
Clinic B, 1st floor, NC Women’s Hospital
In the UNCH Obstetrics Clinic, our LCs and OB providers see mothers with breastfeeding concerns such as pain, low milk supply or postpartum depression. We also offer prenatal consultation for mothers who have a history of breastfeeding difficulties, moms expecting twins or triplets, and consults for adoptive mothers considering induction of lactation.
Scheduling an appointment
To request an appointment, contact the LC Warmline at (984)-974-8078, or toll free at (866) 428-5608. Our LCs will work with you to determine which clinic will best meet your needs.