Breastpump Hire enquiry form

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Breastfeeding Help

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Contact
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Breastpump Hire enquiry form
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Home
Services
Contact
Locations
Web Store
Resources
LINKS- websites and services
Breastpump Hire enquiry form
Events

Breastpump Hire Information and request form

Breastfeeding Help is grateful to be able to support you with your breastfeeding goals.

If breastfeeding goes well the use of a breast pump is not generally required. Some women may choose to express milk either for medical reasons / circumstances ( premature baby or sick baby, low milk supply, resting your nipples when they are damaged, expressing for an adopted baby, relactating, return to work, etc.).

When you choose to hire a pump the process is very easy:

1. fill in the form below, text or call us on 0423109559 please read the terms and conditions for the lease HERE

2. we will get in contact and discuss availability and prices

3. I you decide to go ahead and a pump is available you can request us to reserve a pump for you and confirm this by paying the deposit.

4. Please find the Manual for the Spectra S1 here and Spectra S2 here.

Family name*

Given name*

House number and Street

City*

State/ Territory*

ACTNSW

Post code*

Phone number*

Email Address*

Date Pump is required by*

asapwithin 2 dayswithin 1 weekwithin 2 weeksat a later date

If you choose a later date, could you please tell us by when you need the pump please?*

Do you know what size pump set ( flange size) you require? If yes, please tell us:*

How long would you like to hire the pump for ?*

1 week ( minimum term of hire)2 weeks3-4 weeks5-6 weeksI don't know yet

Do you have private health insurance?*

YesNo

If you have private Health Insurance please provide us with the membership details if you wanted us to include it on your invoice ( Name of insurance, membership details ( name on card, expiry date etc) ) - you can also get in contact and submit these details via phone:

Are you a current client of Breastfeeding Help?*

YesNo

Are you agreeing with the terms and conditions of hire? ( See link above of page)*

YesNo

Do you want to receive any of the following*

Info about Lactation ConsultationsOffers of our other productsEmails about any specials, info, webinars etc.No- not interested

We treat your personal information with utmost consideration of current privacy and confidentiality legislation. We use a secure data management system that complies with the requirements and do not share your information with any third parties. Do you have any concerns about how we store your details?*

No, I am happy for you to store my details in the secure management systemYes, I would like to discuss this in more detail

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Thank you for contacting us. We will get back to you as soon as possible If you would prefer please call us on 0423109559

Breastpump Hire enquiry

Breastfeeding Help Canberra

Phone: 0423109559