1. St. Albans WIC Provider Materials Order Form 2.0

 
Breastfeeding resources are available to St. Albans area provider offices participating in the WIC Mother/Baby Breastfeeding Project.

If you have questions about the project or about using this order form, please contact the WIC Program in the St. Albans District Office.

St. Albans District Office WIC Program
Telephone: 802-524-7970 option 3

St. Albans District Office breastfeeding designee
e-mail: rachael.gregory@state.vt.us

This form can be found at:
https://www.surveymonkey.com/s/StAlbansWIC
1. Please enter your contact information:
2. Fax number:
3. Date of Request:
MM DD YYYY
Month/Day/Year
/
/
4. Professional training options from the Physician Lactation Education Collaborative of Washington:
5. Professional training options (continued):
6. Professional education resources:
Breastfeeding:
A Guide for the
Medical Profession
(Lawrence & Lawrence)
Image as described above
Breastfeeding Answers
Made Simple
(Mohrbacher)
Image as described above
Breastfeeding:
Natural, Biological,
Instinctual, Challenging
(WIC)
Image as described above
Medications
and Mothers' Milk
(Hale)
Image as described above
7. Patient Materials
Amy Spangler's
"What Breastfed Babies Do"
DVD
Image as described above
Born and Raised
the Vermont Way
magazine
Image as described above
Hospital Experience
Image as described above
My Breastfeeding Checklist
Image as described above
My Breastfeeding Checklist
(pediatric version)
Image as described above
Plan for Success Poster
(OB/FP)
Image as described above
Plan for Success Poster
(Peds)
Image as described above
8. To request a follow-up visit, please check the box below. WIC Program staff will contact you to set up an appointment.
9. Would you like to sign up for brief updates on breastfeeding in Vermont via e-mail? These updates will occur no more than 4 times per year.
10. Any questions? Please call the WIC Program at 802-524-7970 option 3 or contact us via e-mail at rachael.gregory@ahs.state.vt.us

Do you have suggestions or feedback for the WIC Program? Please use the text box below. Thanks very much!
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