Request your discovery call.

Please complete this form thoughtfully before scheduling your discovery call. I’ll review your responses in advance so we can use our 30 minutes to discuss your child’s concerns, whether my approach may be a good fit, and how I would structure the next phase of care.

This call is not a full medical consultation and does not include a detailed treatment plan. Individualized recommendations and a complete care plan are developed during the comprehensive consultation. Fields marked with an asterisk (*) are required.

About you & your child

This field is required.
This field is required.
This field is required.
Preferred Method of Contact
This field is required.
This field is required.
This field is required.
Does your child have a PCP
This field is required.

What Brings you to Lumira?

This field is required.
Which areas are you hoping to discuss?

Brief Medical History

This field is required.
How was your child born?
This field is required.
Any complications
This field is required.
This field is required.
This field is required.
This field is required.
Has your child seen any specialists or had any labs or imaging for the concern?
This field is required.
This field is required.

Your Goals & Next Steps

This field is required.
Are you open to a plan that may include conventional treatment, nutrition, lifestyle and integrative options when appropriate?
This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
Scroll to Top