Apply To Join Our Coalition

First and Last Name

Email

Please provide your service area as well as the name of your organization, group or service. Provide contact information.

Please list your certification(s) or professional title, designation:

Breastfeeding Counselor

Breastfeeding Educator

Certified Lactation/Breastfeeding Specialist

Certified Lactation and Feeding Specialist

Community Breastfeeding Counselor

Certified Lactation Counselor (CLC)

Certified Lactation Educator (CLE)

International Board Certified Lactation Consultant (IBCLC)

La Leche League Counselor

Lactation Peer Counselor

Lactation Educator Counselor

WIC Peer Counselor

Doula with Lactation Training

Midwife with Lactation Training

Medical Provider with Lactation Training

Other (please add in next question space)

What Lactation service do you provide or resource document would you like to submit to the coalition for vetting?

Would you like to become a member of this King County Lactation Coalition's Google Group? *

Yes

No

Maybe

Thanks! We received your application and will get back to you shortly.

Quick Links

Contact

206-477-4857

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