Classes | Inland Lactation

Please complete the quick form below so we can save your seat for our Live Zoom Class on June 12th at 11AM PST , send your Zoom link, and verify insurance coverage.

Your information is kept private and secure. We only use it to help coordinate your class and support your feeding journey.

We can’t wait to see you there!

LactationHub + Inland Breastfeeding Center

About You (Mom):

First name

Last name

Phone

Date of birth

Month

Day

Year

Address

Insurance card (front)

Upload an image or document of the front of your insurance card

Insurance card (back)

Upload an image or document of the back of your insurance card

About your baby

First name

Last name

Date of birth

Is your baby covered under the same insurance plan or a different plan?

Same plan

Different plan

Authorization and agreement

I authorize Inland Breastfeeding Center to use my insurance information for covered preventive lactation education benefits

If my insurance does not cover the class, I’ll be notified and can choose a discounted $10 self-pay option or cancel with no cost or obligation