Request an Immigration form

Trauma-Informed • Evidence-Based • Clinically Sound


At Lotus Life Total Wellness, we provide evaluations to support immigration cases with clarity, accuracy,
and care. Our evaluations are designed to help individuals share their experiences in a way that is both clinically
grounded and deeply human — because every story deserves to be understood.

Before You Begin

Our evaluations are conducted virtually by licensed clinicians in Pennsylvania and Delaware. Once your form is submitted, we’ll reach out within 2 business days to confirm next steps.
  • If you are an attorney, please complete this form on behalf of your client.
  • If you are a client, you may complete it for yourself or with your attorney’s help.
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Payment and Process Reminder

  • Standard Evaluation: $1000 (report in 10–14 business days)
  • Expedited Evaluation: $1250 (report in 5 business days)
  • Payment plans and attorney invoicing available upon request.
  • We’ll confirm payment options during your consultation.

Evaluation Request Form


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Next Steps


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You’ll receive an email confirming receipt of your request.

Our team will review your information and contact you to schedule a consultation.

After your appointment, your evaluation and written report will be completed within your selected timeframe.

We’re Here to Help


If you have questions before submitting, please contact us at [email protected].
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All information shared is kept strictly confidential.