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Dr. Referrals
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Myology Referral Pad
Second Lactation Consultant Referral Option
Lactation Consultant Referral
Consultant Name
Mom's Name
Baby's Name
Baby's Date of Birth
Contact Number
Dr. Spears, please evaluate:
Lip Tension
Tongue Tension
Right Buccal Tension
Left Buccal Tension
Relative Additional Comments
