High 5
for Mom and Baby

Hospital Agreement and Application Form

To apply, please complete this fillable Adobe PDF application form and agreement, print, and mail to program coordinator Gwen Whittit at 1840 Trail End Drive, Goddard, KS 67052.

Please be sure to forward copies of any/all current breastfeeding policies from your hospital as well. Thank you for your interest in the High 5 for Mom & Baby Program.

 

 

 


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Best practices. Best health outcomes. Best for Mom and Baby!
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