Lactation Consultation or Information Request

Please fill out this form or call Alisa directly at 618-406-6372.

Home visits are available within 30 miles of downtown Edwardsville, IL.  Otherwise, you may schedule an office visit that will take place at 201 Hillsboro Avenue, Edwardsville, IL.

Name *
Name
Birth or Due Date of Baby/Babies *
Birth or Due Date of Baby/Babies
When is your due date or when was your baby born?
Phone *
Phone
Please explain your current or anticipated challenges with breastfeeding.
Where would you like to receive consultation. If in home, please add your address to the form below.
Address
Address