Dr. Lulu’s Pride Corner Self-Referral Form

🌻 Welcome — we’re glad you’re here.

Dr. Lulu’s Pride Corner is a private, affirming coaching practice for LGBTQIA+ youth and adults. 

We provide emotionally safe, culturally responsive, identity-affirming support for people navigating: emotional safety, identity integration (coming out, sharing or not sharing, self affirmation, etc.), resilience and self-trust (self-awareness _ taking aligned action), navigating family, faith, relationships and cultural pressure, dealing with minority stress, burnout, and overcoming major life transitions.


Please note: Dr. Lulu is a pediatrician, but Pride Corner is not a medical practice. We do not prescribe medication or provide hormone therapy. We do not accept insurance, but we accept your Health Savings Plan (HSP) if it is applicable. This is a 100% coaching and support service, not psychotherapy or crisis care.


How the Practice Works:

Monthly individual 1:1 coaching, delivered virtually nationwide + in-person in Atlanta.


Cash-based only.


Investment:

  1. One-time registration fee $200

  2. Monthly membership $150 per month (3-month minimum commitment) $650

  3. Annual membership $1,800 (save $200) (recommended)


We officially opened our doors on February 1, 2026, and are welcoming our founding clients.


If you are seeking support that honors your full identity, without judgment, discrimination or fixing it, you’re in the right place.


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Email *
Who is enrolling in Pride Corner? *
What is your preferred name and personal pronouns? *
Where are you located?

City + State (or Country if outside U.S.)

 *
Best daytime phone number *
How would you describe your identity?  *

What made you interested in Pride Corner? (paragraph)

 *
What best describes what you’re looking for support with? (check all that apply) *
Required
How did you hear about Dr. Lulu’s Pride Corner? *
Required

Consent & Payment Acknowledgment (kindly check each box)

 *
Required

Payment Instructions (Required to Complete Enrollment) 

Enrollment is confirmed when you schedule your first session.

After submitting this form, you’ll be directed to book your session through our calendar link.

**For Payment, choose the plan that works best for you below AND then return to this form to schedule your first appointment BEFORE you SUBMIT.**

Payment can be completed securely via Stripe.

3-Month Enrollment ($650)  Click HERE 

Annual Enrollment ($1,800)  Click HERE

*Have you completed your payment?*

 *
Kindly click this Calendly link to schedule your first appointment *
I understand and agree to the terms above. *
Required
Full Legal Name (electronic signature) 
Relationship to enrollee (self / parent / guardian)

By typing my full legal name and relationship to enrollee below, I acknowledge that this serves as my electronic signature and agreement to the terms outlined above.
 *
After you click SUBMIT, you will receive your welcome email. Thank you.  
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