Lactation Consultation Liability Waiver

I hereby acknowledge that throughout my contract period with my lactation consultant, services may be provided to me in my home, or in my lactation consultant's office. Regardless of where services are rendered, I acknowledge that my lactation consultant has a limited role in my care.

I understand that by contracting my lactation consultant for their services, I am not guaranteed any particular outcome in regards to my breastfeeding relationship. I understand that my lactation consultant does not make medical or care decisions on my behalf, including decisions regarding when and where to seek medical care, choices during treatment, or any other medical topic. I acknowledge that my lactation consultant is not responsible for the outcome of my breastfeeding journey, nor are they responsible for my infant's health, wellbeing, or growth outcomes.

On behalf of myself, my heirs, administrators, personal representatives, executors, and assigns, I agree to RELEASE AND FOREVER DISCHARGE my lactation consultant, from all damages or causes of actions, either at law or in equity, which I may have or acquire or which may accrue to me, my heirs, administrators, personal representatives, executors or assigns as a result of utilizing my lactation consultant's services. I intend this to be a COMPLETE RELEASE AND DISCHARGE from all liability. I have read all statements contained herein and I realize that I am signing a COMPLETE RELEASE AND BAR to any claims which I have or believe I have resulting from our contract for lactation support services.

Last updated on 4 Feburary 2025. Manna Milk reserves the right to update this consent form without any prior notice.