Online Email Consultation: In order for Dr. Li to have a clear picture of your situation, please fill out the short questionnaire below. If possible, attach photo(s) of the affected area at the bottom of this form. After you have submitted the form, you will receive a confirmation that your form was processed. The form will be sent directly to Dr. Li for her review. Please allow 1-2 business days for a response.**
Patient Name (if different)
Your Email Address: (Required)
Verify Email Address: (Required)
How many years have you had Lupus?
What type of lupus do you have?
Do you know any family member who is diagnosed of lupus?
What symptoms of lupus do you have?
How Serious do you think your Lupus is?
What type of treatment have you used before?
Have you tried any alternative treatment?
How did you hear about us?
(such as Google, WebMD, etc..)
You may attach (optional) Pictures to help Dr. Li understand the situation: