Referral Forms

Norfolk Breastfeeding Clinic works in co-operation with 

Quick Care Pediatrics/Ontario Breastfeeding Network.

Faxes sent to the number on the forms take up to 72 hours to receive.

***In order to ensure prompt processing

please submit form online or print and fax forms to

Ontario Breastfeeding Clinic Fax: 1-833-615-1113.

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