The Neonatal Unit Human Milk Bank is holding a small Open Day on Sunday the 12th June 2016.
Please let us know if you are able to come by completing the form below:

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* 1. Name and Address of Person Registering Attendance

Name

Address

Address 2

City/Town

Email Address

Phone Number

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* 2. How many people will be coming to the Open Day (including yourself)

If more than 4 How Many?

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* 3. Which time would you like to come?

10.00 AM

11.00 AM

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* 4. Are any of the group women that may be able to donate breastmilk (now or at some time in the future)

Yes

Don't know

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* 5. Please let us have contact details of the possible 'Donor'

Name

Email Address

Phone Number

As the Neonatal Unit looks after a wide range of sick and vulnerable babies we would be grateful if you would cancel your visit in the event of illness (coughs, colds, vomiting and / or diarrhea)

Thanks and best wishes