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Request to work with a Healer

Your First Name

Pronouns

Age

Email Address

Phone

Preferred provider(s)

Physical therapy / somatic healing with Dr. Udim Isang

Therapy with Slade

Therapy with Emily

Therapy with Kris

Days/times that you’re available for meeting with your provider

Investment source

Self pay (including out of network)

Self pay - Sliding scale

Subscription (Dr. Udim Isang only)

Accepting insurance necessary

What brings you to us? Anything else that you would like us to know?

Thank you! We will be in touch!

Home
About Us
Our Team
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Contact Us

443-320-2313
info@soulsoilhealing.com

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