Depot Drop Off Log

As of 09/04/2026 this form has been updated. Donor email and phone number are no longer required fields.
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 individual milk storage bags are in a larger bag that 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
2 digit month, 2 digit day, 4 digit yearDate
Donor's First and Last Name
Donor ID 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!)
If the donor requests a receipt of the donation please enter their phone number and email below.
DONOR's Phone Number
DONOR'S Email address
example@example.com
Email
example@example.com
Should be Empty: