For Healthcare Professionals

We welcome referrals from physicians, nurse practitioners, registered nurses, midwives and social workers in British Columbia who wish to connect birthing parents with postpartum or lactation support.

Our clinic provides comprehensive postpartum care for birthing parents and their infants, as well as lactation consultations for feeding challenges before 6 weeks postpartum.

We work collaboratively with referring providers to ensure continuity, clear communication, and coordinated follow-up for shared patients.

Referrals may be submitted using the secure referral form below. Once received, we will contact the birthing parent directly to arrange an appointment and provide updates as appropriate.

If you are a birthing person, please use the Self-Referral Form.

Type of Care Requested

Birthing Parent's Name and Last Name

Birthing Parent's Date of Birth

Year

Month

Day

Birthing Parent's PHN

Birthing Parent's Phone Number

Birthing parents email address (if available)

Residential address

Baby's Date of Birth or Due Date

Does this person require translation services?

Yes

Obstetrical History (G, T, P, A, L)

Are there any complications during the pregnancy or birth you would like us to be specifically aware of, or other health or social concerns relating to the birthing parent or infant?

If the referral is for lactation consultation and support, briefly describe what the main feeding challenge is.

Name and Last Name of Referring Professional (Physician, Nurse Practitioner, Registered Nurse, Midwife, or Social Worker)

MSP Practitioner Number (if applicable)

Facility/Clinic to which consultation communication may be faxed: