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Request A Consultation

If you have been referred for a Tongue Tie/Lip Tie Evaluation or Breastfeeding Evaluation, please submit the following form with the Mother and Child information.  You will receive an phone call notifying you that you have been registered as a patient and information about available appointments.

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We have had a great influx of requests recently and are doing our best to adjust our schedules in order to schedule everyone in a timely manner.  At this time, we will be able to contact you within 7 business days after receiving your consultation request form.