Certified Breastfeeding Educator™ Recertification Form

Please fill out the following information and send to: Debi Bocar, RN, PhD, IBCLC Lactation Consultant Services™ 11320 Shady Glen Road Oklahoma City, OK 73162 Remember to include: Copy of certificate(s) of attendance for 6 Continuing Nursing Education (CNE) Units related to breastfeeding promotion and/or assistance (50 minute sessions = 1 CNE Unit.) $25.00 check payable to Lactation Consultant Services™ Year & Location of participation in the Breastfeeding Educator Program™ Year: __________ Location: ______________________________

Registration Name: Address Street: City, State, Zip: Telephone: Email: Optional Certification pins are available for $5.00. If purchasing a pin, please indicate size preferred: Small (nickel size): __________ Large (quarter size): __________ If you have any questions please contact us at: Debi Bocar, RN, PhD, IBCLC Phone: 405-722-2163 Email: dbocar@aol.com

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