Consent for Virtual Lactation Consultation
Congratulations on becoming a new parent. You or your provider have requested a lactation consultation from Acelleron. By entering into this agreement through acceptance of the consent terms, you agree to receive a Virtual Lactation Consultation from one of Acelleron’s Certified Lactation Counselors. You understand and acknowledge the following:
- You have received and had an opportunity to review and ask questions regarding Acelleron’s Privacy Policy and HIPAA Notice of Privacy Practices.
- Acelleron and its Certified Lactation Counselors will comply with Acelleron’s Privacy Policy and HIPAA Notice of Privacy Practices.
- Depending on the consult type, your Virtual Lactation Consultation may consist of the following: a medical history of you and your baby, a physical assessment of your breasts/chest, and an assessment of how you pump.
- A Virtual Lactation Consultation may involve viewing of your breast in order to ensure correct positioning and breast attachment (of baby and/or breast shield/flange).
- A Virtual Lactation Consultation may involve observation of pumping and suggestions to enhance pumping sessions.
- Neither Acelleron nor its Certified Lactation Counselors will record photos or videos during the Virtual Lactation Consultation.
- A Virtual Lactation Consultation provides guidance on lactation and pumping only. If any guidance provided during the Virtual Lactation Consultation differs from your physician’s recommendations, you should discuss them with the physician prior to making the change.
- You have the option to revoke this consent at any time, by notifying Acelleron by email at: [email protected].
By entering into this agreement through acceptance of its terms when registering for your Virtual Lactation Consultation, you consent to receive a Virtual Lactation Consultation from an Acelleron Certified Lactation Counselor regarding lactation, breastfeeding, and/or pumping.
Effective date: November 17, 2023