Thank you for signing up for the B.E.S.T. workplace support group. We will contact you by email to announce the start date and how to participate via live stream.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. How old are you?

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* 5. What is your race?

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* 6. Are  you currently pregnant?

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* 7. In what city do you live?

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* 8. Have you ever breastfed or pumped?

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* 9. Are you currently pumping/expressing milk at work?

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* 10. Does your workplace have a designated lactation/milk expression room?

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* 11. Where do you work? (If you do not work, put N/A)

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* 12. What topics would you most like to learn about or discuss in the Breastfeeding Education and Support Together (B.E.S.T.) group?

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