Applications Are Currently Open

Important: Submitting a contact form is not the same as submitting a donor application. To be considered for donation, both the contact form and donor application must be completed.

Ready to Get Started?

• Step 1: Complete the contact form below.
• Step 2: Create your Donor Portal account.
• Step 3: Complete your donor application.

Already Submitted a Contact Form?

If you've completed a contact form in the past, our website will not allow another form to be submitted. Please do not create a duplicate record or use alternate contact information. Instead, email donorapplications@prolacta.com for assistance and next steps.

Before You Start

To help make the process as smooth as possible: We recommend reviewing the information below and having it ready before submitting your contact form. Once your contact form is submitted, you'll be prompted to create your Donor Portal account and continue the application process.

The donor application takes approximately 45-60 minutes and includes questions about your medical history and healthcare providers. Before you begin, please have the following information available:

• Contact information (name, phone number, fax number, and email address) for both your healthcare provider and your baby's healthcare provider
• Dates of vaccines received during pregnancy, after delivery, or within the last 12 months
• Dates of illnesses or medical procedures
• Labels for any medications and supplements you take regularly

No medical records or vaccination records are required.

For the best experience: Your progress can be saved for up to 7 days, but we recommend completing the application in one sitting whenever possible. Applications not completed within 7 days will expire and must be restarted.

Things to Know

• Tiny Treasures donors are compensated $1.20 per qualified ounce donated for their time and effort.
• To become qualified and receive compensation, applicants must have a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) and complete both a W-9 form and direct deposit (ACH) form.
• At this time, we can only accept donations from individuals residing in the United States.

By completing this form, you are affirmatively and voluntarily providing your personal information to Prolacta so we may evaluate your eligibility to become a human milk donor.

Ready to begin? Complete the contact form below to start the application process.