Referral Script Form

The LactForms Referral Script form is a highly effective tool for marketing your services to local doctors and healthcare providers. Instantly downloadable as a PDF file and formatted like a prescription pad in portrait orientation with your practice information as a header, it includes space for the parent and child’s names with checkboxes for common presenting issues.

They're ideal for professional printing as tear-off notepads or sticky notes to distribute to local pediatric, OB/GYN, and other healthcare offices (printing permission document included). Available in blue and grey, with more colors coming soon.

Experienced private-practice LCs have been using this marketing idea for decades now as the main source of their doctor referrals and a quick way to increase business. Much better than handing out stacks of your business cards, which often end up jumbled up with other specialists' cards in a forgotten area of provider offices.

Providers find printed notepads and sticky pads convenient way to refer their patients to you for lactation services. They just check off a few boxes, tear off the page, and hand it right to their patient, who then has your contact information and a handy reminder to make an appointment with you right away. 

Professionally printed size:  4.25" x 5.5" (10.795cm x —If you prefer a different size (or need to fit European size pages), most printing companies can adjust the image. But if they require a different image size, it can be provided it at no extra charge, just ask!

INSTANT DOWNLOAD FILES INCLUDE (to accommodate printer preferences):  

1. 8.5" x 11" (21.6cm x 28cm) page with ONE image on the page—No printer marks
2. 8.5" x 11" (21.6cm x 28cm) page with FOUR images on the page—No printer marks
3. 9" x 11.5" (21.6cm x 28cm) page with ONE image on the page—With printer marks
4. 9" x 11.5" (21.6cm x 28cm) page with FOUR images on the page—With printer marks

ALSO INCLUDES:

1. Quick Start Guide
2. Header Instructions
3. Printing Permission (copyright release)

HEADER NOTE:  Except for the HeaderBox header version, the other header options are shorted to the name, credential, phone number, email, and website for easier reading on the smaller pad size (a quarter of the size of a standard page).