Request Breastfeeding Resource Directory

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First Name *
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How many directories should we ship for you to distribute from April 2007 through March 2008?   

2007 Resource Directory Questionnaire 

1) How / from whom did you obtain this Resource Directory? (Please check all that apply):

 Pediatrician                             Breastfeeding Task Force Event

 Obstetrician / Gynecologist     Public Health Department

 Hospital                                  Ordered From Task Force Website

 WIC Office                             Other , please specify  

 

2) How often will you use this Resource Directory?

 Daily                                     Monthly (at least once/month)

 Weekly (at least once/week)   Other , please specify  

3) In what capacity will you use this Resource Directory? (i.e. with patients, personal use)

4) What additional information should be included in the Resource Directory?

 

5) How would you describe yourself? (Please check all that apply):

               Mother / Parent                      Lactation Consultant / Lactation Educator

               Physician                              WIC Employee

               Nurse                                    Other , please specify  

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