Radical Healing Collaborative Appointment Request Form - Medication Management

Radical Healing is excited to add more inclusive psychiatric medication management providers. Appointments are available now for in person appointments in Chapel Hill 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. (Updated 12/5/2023)

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

Insurance and Payment Information