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The Lactation Foundation
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Forms

Request an Appointment

New Patient Forms

Please complete the following form AFTER you have scheduled your appointment:

Intake Form – English     /    Formulario de Admisión – Español

For WIC Clinics

To refer a WIC client to the Lactation Foundation: WIC to LF Referral Form

If you need assistance, please call our office at 713-500-2800, option 1.

Lactation Foundation
at McGovern Medical School

2636 South Loop West, Suite 650
Houston, Texas 77054
[email protected]
713-500-2800 (option 1)

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