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![Cover Photo Donate MIlk.jpg](https://static.wixstatic.com/media/dbd2ea_773fa7618bed47639190bc2e80e1d619~mv2.jpg/v1/fill/w_134,h_75,al_c,q_80,usm_0.66_1.00_0.01,blur_2,enc_auto/dbd2ea_773fa7618bed47639190bc2e80e1d619~mv2.jpg)
ORDER MILK
HOSPITAL OR PHARMACY ORDER FORM
FAMILY ORDER FORM
Pharmacies:
Frozen pasteurized donor human milk is currently available for purchase without a prescription for up to 10 bottles (120 mL ea), at the following pharmacies:
CALGARY
728 Northmount Drive NW, Calgary AB, T2K 3K2
Phone: 403.289.9181
100 - 7015 Macleod Trail SW, Calgary AB, T2H 2K6
Phone: 403.253.6773
142 - 3715 51 St SW, Calgary AB, T3E 6V2
Phone: 403.249.4346
PHARMACIES
HOW TO WRITE A PRESCRIPTION
![How to Write a Prescription.jpg](https://static.wixstatic.com/media/1a18f1_c78a1440c2034abf8f79d800a1923eb0~mv2.jpg/v1/fill/w_78,h_104,al_c,q_80,usm_0.66_1.00_0.01,blur_2,enc_auto/How%20to%20Write%20a%20Prescription.jpg)
How to Write a Prescription:
If more than 10 bottles are needed:
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Recipient Name
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Recipient Date of Birth
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Recipient (last name) if prenatal indication
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Recipient Physician: __________________ (please print)
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Reason for supplement --gestational diabetes, hx of low milk supply, delayed lactogenisi II
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Duration – X 2weeks/one month/as needed
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