Request An Appointment

If you are interested in making an appointment with Live4Lali, please fill out the following form. A member of our team will quickly respond to confirm your needs and requested appointment date and time. If you’d like to call to set up an appointment, we can be reached at 844-584-5254 (LV4-LALI)

Live4Lali is committed to protecting your privacy. We hold confidentiality in the highest regard and in doing so, maintain a strict information collection policy. We are required by law to maintain the privacy and security of your protected health information. We will not use or disclose your personal information unless you provide written authorization. You may revoke your authorization at any time, in writing, but only as to future uses or disclosures and only where we have not already acted in reliance on your authorization.