I understand that Natalie Diaz will not perform any medical procedures nor will she go against any recommendation your healthcare provider has offered. She will, instead, assist with preparing a detailed list of questions and concerns you may present to your provider for further clarification.

She will not provide me or my baby “treatment” via oral medications(prescription or over-the-counter) but can point you towards what you might need so that you can discuss treatment options with your provider or Pediatrician.

I understand and agree to inform my healthcare provider and/or Pediatrician about any supplements (galactagogues) that are commonly used to “increase” or “boost” breastmilk production BEFORE I use them.

I understand that I am responsible for informing natalie Diaz of changes I feel are necessary for her to know while she is assisting me with Lactation Services and during follow-up services.

I give my consent for Natalie Diaz to release any information she has collected during our visit about myself or my baby to our healthcare provider, pediatrician, referring providers, and/or other Lactation Specialists should it be deemed necessary.

I understand that for this lactation visit and any follow-ups I may have, Natalie Diaz will protect the privacy of my personal health information as required by law and the Health Insurance Portability and Accountability Act (HIPPA).