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High 5 for Mom & Baby Application & Renewal Form

Kansas Hospitals and Birth Centers:

Please use this online form to apply for High 5 for Mom & Baby / High 5 for Mom & Baby Premier
recognition (new facilities) or for your annual renewal (current High 5 facilities).

If you have questions about High 5 or the application process, please contact
program coordinator Gwen Whittit at coordinator@high5kansas.org. 

Thank you for your commitment to helping ensure successful breastfeeding for Mom & Baby!