Lymphedema Products

Virtual In Service Request

Luna Medical > Virtual In Service Request

Please use the form below to request a virtual in service with Marianne Luh, Luna Medical’s Founder and Patient Care Specialist.

    All fields are required

    First Name and Last Name

    Title (PT, OT, etc.)

    Healthcare Network

    Clinic Name

    Address

    City

    State

    Zip Code

    Work Email

    Personal Email for Upcoming Events

    How many new upper extremity patients do you see on average per month?

    Preferred date and time for virtual in-service (Option #1. All times CST.)

    Preferred date and time for virtual in-service (Option #2. All times CST.)

    How many new lower extremity patient do you see on average per month?

    What percentage of your patients have commercial insurance as their Primary Payor?

    Have you or do you refer lymphedema patients to Luna Medical?

    If the answer is yes, how would you rate our services on a scale of 1-10?

    Are there any comments you would like to share about Luna Medical's Team of Patient Advocates that we can share with other lymphedema clinicians on our home page?

    If you don't mind sharing, which providers do you currently refer commercial insurance to?

    If you don't mind sharing, which providers do you refer private pay to?

    Note: We are in the process of launching a private pay website however in the interim, please note that we offer private pay pricing.

    Additional Comments