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HOW TO ORDER DONOR MILK

All milk is dispensed by a physician order (inpatient) or prescription (outpatient).
Orders for outpatients:
Please mail this order form to the milk bank. All prescriptions for outpatients will be filled with Term pasteurized milk. If necessary milk from donors with low dairy diets (fewer than two servings dairy per week) may be available on request.
Outpatient family responsibilities: Call the Milk Bank with the following information:

• * Name of primary contact for the patient
• * Address and phone number of above
• * Name and phone number of prescribing physician
• * Patient’s Insurance information or Medicaid number (if applicable)

It is the responsibility of the patient’s family or guardian to contact the Milk Bank by 5pm Tuesday each week to confirm that an order is needed. Milk will not be shipped otherwise.

Order forms should be mailed to:
Mothers' Milk Bank of New England
P.O. Box 600091
Newtonville, MA 02460