CONSENT FOR TREATMENT
I hereby give consent for a Lactation Consultant to observe me
nursing my child, to examine and/or touch my breasts should this
become necessary during the course of breastfeeding assistance.
I understand that all medical care is to be provided by my
physician.
The Lactation Consultant has my permission to contact my
physician(s) with her findings and/or any pertinent information
regarding my child’s care or mine.