Get In Touch

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

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May we leave you a voicemail? *

Yes

No

May we send you a text message? *

Yes

No

Preferred Visit Type: *

In-Person

Virtual

First Available

How would you prefer to schedule your visit? *

Text

Phone

No Preference

*

By checking this box, I acknowledge that I understand that Lucera Health does not accept insurance and that I have reviewed the service fees on our website.