Lactation Consultant to Maternal Medicine Specialist Referral Form

Streamline Maternal Health Referrals with Paperform

When breastfeeding challenges require specialized medical intervention, clear communication between lactation consultants and maternal medicine specialists is essential. Our Lactation Consultant to Maternal Medicine Specialist Referral Form template helps healthcare providers document complex cases, ensure continuity of care, and prioritize patient safety through secure, structured referrals.

Why Healthcare Providers Choose This Template

Lactation consultants, midwives, doulas, and maternal health clinics face unique challenges when referring patients for specialized care. This template addresses common pain points:

• Comprehensive clinical documentation capturing breastfeeding complications, infant weight gain patterns, maternal health conditions, and medication concerns
• Structured information flow that ensures maternal medicine specialists receive all relevant details to make informed decisions
• Time-saving efficiency for busy lactation consultants who need to submit thorough referrals quickly
• Better patient outcomes through seamless coordination between lactation support and medical specialists

Who Benefits from This Template

This referral form is designed for:

• Lactation consultants (IBCLCs) managing complex cases requiring medical evaluation
• Midwives and doulas supporting postpartum families with feeding challenges
• Maternal health clinics coordinating care between lactation services and medical specialists
• Pediatric practices addressing infant weight concerns alongside maternal health issues
• Telehealth lactation services needing structured digital referral processes

Key Features for Maternal Health Workflows

Our template includes specialized fields for:

• Patient and infant demographics with secure information collection
• Breastfeeding history and complications including latch issues, supply concerns, and pain
• Infant weight tracking with percentile concerns and feeding frequency
• Maternal health conditions affecting lactation (thyroid disorders, PCOS, diabetes, postpartum complications)
• Current medications and compatibility concerns with breastfeeding
• Previous interventions tried by the lactation consultant
• Urgency indicators to help specialists prioritize cases
• Supporting documentation upload for growth charts, photos, or previous medical records

Why Paperform for Healthcare Referrals

Healthcare providers need forms that work as hard as they do. Paperform delivers:

• Professional, branded forms that reflect the quality of your care
• Conditional logic to show relevant fields based on specific complications or concerns
• HIPAA-aware workflows when combined with appropriate business associate agreements
• Mobile-friendly design for consultants documenting cases during or after home visits
• Integration with practice management systems via Stepper, connecting referrals to your CRM, EHR, or communication tools

With Stepper, you can automate what happens after submission: send confirmation emails to both referring provider and specialist, create tasks in your practice management system, trigger appointment scheduling workflows, or notify care teams via Slack. This means less administrative burden and faster responses for families in need.

Reduce Administrative Burden, Improve Care Coordination

Manual referral processes often mean faxed forms, phone tag, and lost information. This digital template eliminates friction:

• Lactation consultants complete referrals in minutes from any device
• Maternal medicine specialists receive organized, complete information instantly
• Families experience less frustration and faster access to specialized care
• Your practice maintains professional documentation for continuity and compliance

Built for the Realities of Maternal Healthcare

We understand that lactation consultants often work independently or in small practices, juggling clinical work with administrative tasks. This template respects your time while ensuring you provide thorough, professional referrals that specialists can act on immediately.

Whether you're an IBCLC in private practice, part of a hospital lactation team, or working with a maternal health nonprofit, this template adapts to your workflow—not the other way around.

Get Started in Minutes

With Paperform's intuitive editor, you can customize this template to match your referral protocols, add your branding, and connect it to your existing tools. No coding required, no IT department needed—just professional healthcare forms that work.

Trusted by healthcare providers worldwide and backed by SOC 2 Type II compliance, Paperform helps you focus on what matters most: supporting families through their feeding journey and ensuring timely access to specialized care when complications arise.

Start streamlining your maternal health referrals today with this comprehensive, ready-to-use template.