Radical Healing Collaborative Appointment Request Form - Primary Care and Other Medical Care

Radical Healing is excited to add more inclusive medical care providers. Appointments are available now for in person appointments in Durham or virtual telehealth appointments for residents across the entire state of North Carolina.  To begin the onboarding process with us, please complete the following form. Someone will be in touch with you within a few days to set up your initial onboarding and intake paperwork.

Note: We are currently onboarding those with Blue Cross Blue Shield, Aetna, United Healthcare, and Cigna insurance plans, and those who wish to be self-pay. We will begin onboarding those with Medcost in the coming months. Though we are now able to accept some Medicare/Medicaid insurance plans, please note that prescriptions will likely need to be for paid out of pocket. (Updated 5/6/2024)

Please complete the following section for yourself or if you are a legal guardian, your dependent minor.

Insurance and Payment Information