Membership – Homegrown Pediatrics

Interested in Membership?

Homegrown Pediatrics is a membership based practice and does not accept any insurance. This allows for increased access to your doctor! Currently, Dr. L’s panel is full – please fill the information below to be added to the waiting list. Dr. L will enroll a few newborns each month and pull others off the wait list as space opens. When a slot is open, Dr. L will text you a link to schedule a meet & greet and ensure a good fit.

"*" indicates required fields

Parent 1 Name*

First Name Last Name

Primary Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent 1 Cell Phone*

Please enter a valid phone number.

Parent 1 Email*

example@example.com

Parent 2 Name

First Name Last Name

Parent 2 Cell Phone

Please enter a valid phone number.

Parent 2 Email

example@example.com

Please list birthdays (or due dates) of the kids you would like to enroll.*

Any specific questions that you have for Dr. L?*

How did you hear about Homegrown Pediatrics?*

What type of insurance does your family have? (although we do not bill insurance, we are a better fit for some than others)*

PPO

No insurance

HMO

Medicaid

Tricare

Other

Other Insurance

Please prove that you are human

Name

This field is for validation purposes and should be left unchanged.