Breastfeeding Education and Support Together (B.E.S.T.) Registration

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?

Under 18

18-24

25-34

35-44

45-54

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* 5. What is your race?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 6. Are you currently pregnant?

Yes

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* 7. In what city do you live?

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* 8. Have you ever breastfed or pumped?

Yes

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

Yes

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

Yes

Not sure

Breastfeeding Education and Support Together (B.E.S.T.) Registration

Question Title

* 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?