8669 Commodity Circle, Suite 490 • Orlando, FL 32819
Web: milkbankofflorida.org P:407-248-5050 • F: 407-370-4340 • E: INFO@milkbankofflorida.org

It is important that we keep in touch with you on a regular basis to learn of any concerns you may have and be attentive to your health and well-being during the time you are actively collecting milk for medically fragile babies. Kindly complete this form online and submit it to us (or print and include it) when you ship or drop off your milk.