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Healing
Heart
Ministry

CALL US : 1-251-545-8418

Healing Heart Ministry
Forms
Please print forms and complete and bring to first meeting
Adult Intake
Form
Child Intake
Form
Release of Information
Insurance Form
Hula Hoop
Form
Please Click on the Form to open and print your forms.
FEES
Sliding Scale Based on income for Private Pay Clients
Intake Fee $100.00
$60,000 and Below $70.00
$61,000 - $70,000 $80.00
$71,000 - $90,000 $90.00
$91,000 and above $100.00
Our Fees are based on each client's annual income
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