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Use this form to pay the milk processing fees and submit information for donor milk to be picked up at Mid-Atlantic Mothers’ Milk Bank in Pittsburgh, picked up at a dispensary, or brought home from a hospital or birth center.

For donor milk, if use will exceed two weeks or will be covered by insurance, do not use this form and instead follow these outpatient procedures.

Our payment processing system is currently offline, after completing the dispensary order form please call 412-281-4400 ext 113 to confirm payment.