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Minnesota Breastfeeding Friendly Maternity Center Designation
Expedited Application
Complete this PDF form electronically using Adobe Acrobat or Adobe Reader 10.0 or later
(free download available online). Save the form to your computer and submit it by email as
an attachment to [email protected], along with a copy of your facility's Baby Friendly
designation award letter. Submissions are accepted at any time, but are reviewed on a semiannual basis. Submit an application by May 31 or October 31 for review by the end of the
following month. Contact Linda Dech at [email protected] with questions.
Note: The Expedited Application form is intended for maternity centers that have an active
Baby Friendly designation, awarded by Baby Friendly USA. If your facility does not have this
designation, please apply for stars using the Application Cover Sheet form and the individual
Step Application forms.
Maternity Center Information:
Facility Name (to be printed on certificate):
Mailing Address:
City:
State: MN
Zip Code:
Contact Information:
Name/Credentials:
Title:
Email:
Phone Number:
Submission Authorization:
This facility has been designated as Baby Friendly by Baby Friendly USA. The official
designation award letter is attached to this application.
Indicate the date of designation:
I acknowledge that the facility's CEO/COO is aware of the submission of this application
to the Minnesota Department of Health (MDH) appointed designation committee.
I consent to having this facility listed as a 5-star designee and a Minnesota Mother-Baby
Ten STEPS award recipient on the MDH public website.
Indicate the web address (URL) to link to the facility:
Submit by Email