Sign Up for Breastfeeding Buddies

Please provide the following information.

Note: You should be aware that sending personal information through the internet may not be secure. Once your information is received by the Porcupine Health Unit, it will be managed according to our privacy policies. For more information, please refer to our Disclaimer and Privacy statements on this website.

About You

Your name:

Mailing address:

Postal code:

Daytime phone number:

Please enter either your baby's birthday or your expected due date: