Depot Drop Off Log

Drop Off Log
Use this electronic log in lieu of the paper drop off log. Log is to be completed by depot staff and will be sent to The Milk Bank immediately upon submission.

Please ensure that each bag is clearly marked with donor's full name and donor number.

Please also ask the donor if they have remembered to complete an online follow-up survey; if not, please remind them to do so using the link in their approval email.
Depot Name
Date Received

MonthDayYear
Date
Donor's First and Last Name
Donor ID Number
DONOR's Phone Number
Estimated Number of Ounces
Months Expressed
Received By
If you need a copy of this entry for your depot please enter your email address. DO NOT ENTER A DONOR'S EMAIL.
example@example.com
Description of Donation (please give details!)
Email
example@example.com
Should be Empty: