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Policies and Procedures

Business Definition

Carly Marks is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC)

Year of IBCLC certification: 2014

Next recertification date:  October 2024

Recertification method : continuing education

California RN: 665665 renew 11/30/2024

Company Name: Marks Lactation Support

Husband and Wife Sole Ownership

NPI: 1356735583

EIN: 814726609

Mailing address: 13374 Terraza Playa Cancun San Diego, CA 92124

Phone: 619-481-1000

Fax: 844-278-5429




Marks Lactation Support  employs subcontractors to perform business services.


Name: Leanne Boyce, MS CCC-SLP

Contact Information:


  • Lactation Visits as scheduled

Name: Steven Willhelm, APC

Contact Information:


  • Reviews business practices and documents (including this document)


Name: Blum and Clark

Contact Information

  • Files annual taxes and generates appropriate documentation


Mission Statement

Marks Lactation Support aims to empower parents in San Diego to feed their baby their way, with up-to-date information, personalized goal-setting, and supportive strategies. 

IBLCE Code of Professional Conduct

I adhere to the IBLCE Code of Professional conduct as found here.

Non-Discrimination Policy

Marks Lactation Support does not discriminate against employees, business associates, or clients on the basis of race, ethnicity, national origin, citizenship status, sex, gender identity, sexuality, religion, physical ability, or marital status.


Marks Lactation Support is an inclusive practice and acknowledges that not all lactating persons identify as female or use the word mother.

Marks Lactation Support seeks continuing education on cultural competency, inclusivity, racial inequities, and LGBTQIA concerns in order to provide the best possible care to all families.

Policies and Procedures Review

These Policies and Procedures have been reviewed by Steven H. Willhelm, Esq.

These Policies and Procedures will be updated and reviewed by Steven Willhelm, Esq as necessary.

Services Provided

  • Lactation Visits

  • Lactation Professional Mentorship

  • Facilitating Support Groups



Client’s home: (up to 30 miles from 13374 Terraza Playa Cancun, San Diego, CA 92124)


Average Length of Initial Visit: 90 minutes

Average Length of Follow Up Visit:60 minutes

Average Length of any other visit type:60-90 minutes

Regular Business Hours: Mon-Fri 0900-1400 plus occasional evening and Saturday appointments


Visit Policies

Marks Lactation Support  provides all prospective clients with a Consent for Care. This form will be provided to the client when scheduling the visit, and must be signed before Carly Marks, BSN, RN, IBCLC travels to the client’s home. Client has the right to refuse any treatment or intervention offered, and this refusal will be documented.  All attempts to continue a comprehensive visit will be made, and client will be informed of any limitations which arise from honoring Client’s refusal of treatment or intervention.


Consent is verbally requested before touching client or client’s minor child. Client may withdraw consent to be touched even if consent was previously given verbally or in writing. Withdrawal of consent will be documented.


Marks Lactation Support uses a Tanita scale to weigh the client’s baby before and after feedings. The scale will be cleaned at the beginning and end of each visit. The scale was last calibrated on 1/3/2018 by Tanita.  The demo doll weighs 2lbs 9.1oz, and can be weighed at any time to confirm accuracy. If there is any question regarding scale accuracy, the batteries will be changed. If a discrepancy remains, the scale will be returned to the manufacturer.

  • The baby will wear a diaper, (+ clothes, if desired)  while being weighed for a weighted feed, and will be wearing the same diaper (+clothes if worn during pre-weight) if a post-feed weight is taken.


Marks Lactation Support may recommend the use of certain products:


  • Some products may be provided (included in the fee for the visit)

    • Marks Lactation Support accepts free unopened or sterilizable products from a gifting economy community

  • Clients will be referred to purchase items from a third party (often, but not limited to links on

    • Marks Lactation Support  is not an affiliate with any third party


Marks Lactation Support may refer clients to other professionals for continued care.

Marks Lactation Support does not accept fees for these referrals

Marks Lactation Support  will provide more than one referral option


Client visits will be canceled in the event of provider illness or personal emergency and rescheduling is not guaranteed. In the event of cancellation for illness or personal emergency, clients will be notified by their preferred method as provided during intake.

If Marks Lactation Support is not available due to scheduling constraints, vacation, personal illness, or illness of an immediate family member :

  • New appointment requests will not be scheduled.

  • Best efforts will be made to provide the IBCLCs listed in the policy on referrals, as well as information on breastfeeding support groups in the area.

  • Marks Lactation Support will not respond to messages from current clients during vacation, planned closure,  personal illness, or personal emergency.

  • Best efforts will be made to respond to messages from current clients during an illness of an immediate family member.

  • Marks Lactation Support is not obligated to inform clients or potential clients of unavailability due to vacation, planned closure, illness, or emergency.

  • Marks Lactation Support has no  backup arrangement with any provider.

  • Best efforts will be made to notify active clients of any planned closures.


Handwashing occurs:

  • After entering Client’s home

  • Before touching Client or Infant

  • After using the bathroom

Latex-free gloves are worn:

  • When examining an infant’s suck and oral anatomy


Fee for Service Payment Policies


  • Marks Lactation Support accepts payments at the time that services are provided.

  • All services are non-refundable.

  • A discount will be provided for follow up visits.

  • Clients are provided with a superbill with lactation services coded to S9443, 99404, or others, as applicable.

  • A discount  is available based on the following eligibility requirements:

    • WIC participant

    • Referral from other provider

    • TriCare beneficiaries 



  • Fee Schedule posted in scheduler

  • Travel fee or cancellation fee as applicable $50

  • Surcharge for Travel Outside Service Area $40 per visit

  • Payment methods accepted

    • Cash

    • Personal Check payable to Carly Marks

    • Credit Card processed through PCI-compliant processor, if client signs consent for name and email sharing to:

      • SquareUp


Marks Lactation Support  provides a superbills to "Self Pay" Client, for reimbursement. Client is responsible to file claim with their insurance.  Client pays at the time of service according to the payment policies above. Best efforts will be made to provide any information as required by Client’s insurance. This services is offered as a courtesy and is no guarantee of reimbursement.


Carly Marks, RN  is a TriCare authorized provider for procedure code 99404. Clients must provide their Defense Benefits Number or Sponsor’s SSN, date of birth, and relationship to sponsor prior to the visit to receive the Tricare discount. Carly Marks, RN agrees to accept the TriCare  negotiated rate + 15%. Cancellation fee as applicable.  Client is responsible to file claim with their insurance.  Client pays at the time of service according to the payment policies above. Best efforts will be made to provide any information as required by Client’s insurance. This services is offered as a courtesy and is no guarantee of reimbursement.  

If client’s coverage lapses, changes, or terminates prior to a scheduled visit, client is responsible to cover all charges at the self-pay rate and to inform Marks Lactation Support of this change.


If Carly Marks, RN will not be on time for a scheduled visit, Carly Marks, RN will attempt to communicate an updated arrival time by text message, or email by secondary means.


For home visits, all pets must be secure in a separate room behind a closed door or in a crate for the duration of the visit. Marks Lactation Support must be notified of any service animals who will be present prior to the visit.


Client may grant consent for others to be present during the visit. These names must be provided to Marks Lactation Support in advance and will be collected as part of the Consent for Care.


Marks Lactation Support  will provide Robert Marks, MD the address for all home visits. Clients will be providing this consent prior to the visit. If Client declines to provide this consent, Marks Lactation Support will not enter into Client-Consultant relationship, and provide referrals per the above policy.

Marks Lactation Support will ask client for consent, ahead of time, for any intern, student, or assistant to attend visits.

Clinics, Classes and Support Groups


  • Name of group: Support Groups as Carly Marks, RN, IBCLC may substitute for colleagues, in various settings, at various times

  • Type of group:

    • Parent-to-Parent support, specific to breastfeeding/chestfeeding/pumping parents and their infant(s).  It is asked that only breastfeeding/chestfeeding/pumping parents attend this group, with their infant(s). Marks Lactation Support reserves the right to recognize exceptions to these guidelines.  


  • Services offered:

    • Facilitated group discussion

    • Scale for pre- and post-feed weights (refer to scale policies above)


  • Location details:

    • Each Occurrence may be different

    • As needed

    • Support group is completely free, and open to parents as described, above.


Marks Lactation Support reserves the right to cancel any group offering for any reason without prior notice.


Other professionals are welcome to attend group offerings, with advanced,notice and for observational purposes only. They are requested not to participate. They may not offer marketing items to group participants.

Disclaimer: Breastfeeding Support Groups facilitated by Marks Lactation Support is

Parent-to-Parent support, specific to lactating parents and their infant(s).  A scale is available for participant’s use. It is participant’s choice to record information on the group sign-in.  Conversation regarding all things breastfeeding and parenting is shared, in confidence, and it is expected that participants respect each other’s confidentiality.  Although Facilitator will apply their knowledge of breastfeeding when speaking with participants, these interactions cannot replace Lactation Consultations, and, as such, advice gained through the support group activity should not be relied upon other than as general advice. Each parent and child clients have their own idiosyncratic

issues which can only be truly tailored to each client group through one on one Lactation Consultations.



Marks Lactation Support offers virtual lactation visits.

Scheduling Logistics

Cancellation Policies

If client cancels the visit for any reason, $25 cancelation fee will apply.  Marks Lactation Support reserves the right to refuse to reschedule the visit.


If Marks Lactation Support must cancel an appointment for any reason, no charges to the client will apply.  Marks Lactation Support reserves the right to cancel appointments for any reason without notice.



Phone, Email, postal service or fax as requested

Prospective Clients

Marks Lactation Support maintains a website at hosted by Wix. Contact phone number and email address are publicly posted. Website has a contact form that accepts submissions; data from this contact form is stored.


When a phone call, email, and/or text comes in from a prospective client comes in, the policy is to:

  • Send a text message or email reply within 48 hours

  • Send a link to my online scheduler

  • Send a link to my website for more information on my services

  • Marks Lactation Support does not provide clinical support or counseling to prospective clients


Current Clients

Clients receive 2 weeks of follow up support by email and/or secure messaging  as part of their fee for services, to include services paid via insurance.

Secure Messaging

Marks Lactation Support provides secure messaging to established clients through

  • Encrypted and secure email via Gsuite, preferred method of Marks Lactation Support


Secure messages will be replied to

  • Within 24 hours

  • During business hours


Follow-Up Communication regarding each visit

  • Will be sent within 24 hours

  • Client will receive the same report sent to providers, and notified to whom the report will be sent.  The email will include references, referrals, and other information discussed during the visit.

  • Report will be sent to Infant’s provider for every visit, unless documented otherwise

  • Report will be sent to Client’s provider, if there is anything remarkable to report on Client, or at Client’s request

  • Report will be sent to any HIPAA-covered entity, upon Client’s request.  Client will be notified.

Marketing Communications

Marks Lactation Support plans to send periodic marketing emails through (a service to be determined). Clients are required to give express consent before being added to an email marketing list. Clients may request to be removed from the list at any point by (sending an email request, clicking a link in the email).  Marks Lactation Support will never sell or rent this marketing list.


Social Media Communications

Carly Marks  or Members of Marks Lactation Support may maintain private social media accounts for personal use. Connection or direct message requests made by clients or prospective clients through these platforms will not be accepted.


Marks Lactation Support maintains public social media accounts for marketing purposes on the following platforms: Facebook, Instagram, WIX website. All photos appear by express permission of the owner of the photo and all persons appearing in the photo. No client photos or videos will be published without express written consent. Clients and/or their minor children will not be named in posts on social media without express written consent.


Marks Lactation Support will not provide direct clinical support or counseling or advice on any social media platform, either public or private. Public accounts are for marketing purposes only,  to offer general information.


Social Media Policies for Marks Lactation Support are posted on all public social media channels.

Website Communications

Website Terms and Conditions are publicly posted on the website for Marks Lactation Support.


HIPAA Notice of Privacy Practices is publicly posted on the website for Marks Lactation Support.


Contact form entries via the website are stored

  • In the Wix platform

  • Prospective Client may request an appointment via ChARMhealth

  • Client to IBCLC relationship is established upon signature of Consent for care, Privacy and Payment policies

  • Client’s email is stored in Gsuite platform with appropriate security & privacy measures


Marks Lactation Support abides by all federal, provincial, state, and local regulations regarding copyright. No text, image, or graphic content will appear without the express permission of the copyright or trademark holder.

Security Policies

Record Retention Policies


Marks Lactation Support is subject to the record retention laws of CA, and is required to keep client records until 21 years after an in-person visit. Records include email correspondence, and Electronic Health Record.


Clients may request a copy of their chart or that of their minor child at any point during the record retention period. Request must be made in writing to the listed address for Marks Lactation Support. Receipt of the request will be acknowledged by Marks Lactation Support and records will be mailed within 30 days of acknowledgement of the request.


Marks Lactation Support provides records for free within 6 months of the last in-person visit; after this period, a fee of $25 will be charged and must be paid in advance.

Physical Security


  • Client files are digital, but paper charting is back-up, in the case of technological failure

  • Physical records are scanned as soon as possible, and entered into Client’s file, then shredded before disposal.


Digital Security

Compliance with Privacy Regulations

Marks Lactation Support is in compliance with all applicable federal and provincial/state regulations with respect to the use of technology for healthcare.


Notice of Privacy Practices is publicly posted on the website for Marks Lactation Support.


All devices used for client care will be secured by a passcode and/or biometric identification.


The following person has access to the passcode in case of emergency Robert Marks, MD.


Marks Lactation Support uses Google Workspace for client care. The following safeguards are in place:

  • Password protection

  • Two-factor identification



Marks Lactation Support will not use any free cloud-based services for client communication or file storage.


Email services and document storage are provided through:

  • G-Suite, with a Business Associates Agreement for HIPAA compliance


Phone services are provided through:

  • T-Mobile


Website Terms and Conditions are posted publicly on the website

Personal Policies

Carly Marks, BSN, RN, IBCLC  is receiving COVID-19 vaccination.


Carly Marks, BSN, RN, IBCLC actively pursues continuing education related to lactation management, infant and child development, parental wellness, communication skills and cultural competence.


Carly Marks BSN, RN, IBCLC is a mandatory reporter for signs of child abuse or neglect, elderly abuse, and domestic violence.  This does not include investigation or confirmation. She will call County Social Services Department's Child Protective Services Child Abuse Hotline at (858) 560-2191 or (800) 344-6000, according to guidelines provided.


Gift policies:

  • Marks Lactation Support accepts gifts from clients when services are concluded.  

  • If applicable, gifts may be donated to San Diego Breastfeeding Center Foundation, or The Wounded Warrior Project.

  • Marks Lactation Support refuses or destroys any and all donations, gifts, samples, or services from any company or subsidiary company not in compliance with the WHO Code of the Marketing of Breastmilk Substitutes.

  • The policy of Marks Lactation Support is to purchase all necessary supplies at retail and/or wholesale if appropriate.


For home visits:

  • I have a policy to accept offers of water from clients.

  • I will remove my shoes.

  • I may request to use the bathroom in a client’s home.


Update 12/14/22

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