Breastfeeding Support Program
Program Registration

Thank you for your interest in the Lehman College Lactation Room in Carman Hall,  Room 187!
This room was designed for mothers to have a safe place to come to breastfeed and pump in a private and clean setting.  

Please fill out the form below to begin processing access to the room. Once you have filled out the form we will contact you to inform you of when your key to the lactation room is ready. Please allow 5-10 business days for the process to be complete.

If you have any questions please contact: Ashmini Hiralall, Director, Lehman Wellness at ashmini.hiralall@lehman.cuny.edu.
     
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Today's Date *
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Name *
First, Last
Campus Department (if student N/A) *
Phone *
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Email *
University Affiliation *
If you are an undergraduate student, what is your class standing?
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Planned Length of Time to Breastfeed *
Other time length
If you are out on leave, what is your planned date to return to work
How frequently do you anticipate using the room *
Do you have a preferred time (check all that apply) *
Required
Is this your first experience with breastfeeding and pumping? *
Do you already own a personal electric breast pump? *
Would you be interested in resources or other types of support? *
If yes, what kinds (check all that apply)
What would you do if this room were unavailable?
How did you learn about the Breastfeeding Support Program? *
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Please put any additional comments or questions here
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