HEAL Administration

Health Education Assistance Loan (HEAL) Forms

HRSA 502-1 Repayment Schedule (Variable Rate) (PDF - 32 KB)
HRSA 502-2 Repayment Schedule (Fixed Rate) (PDF - 53 KB)
HRSA 504 Lender's Application for Contract of Federal Loan Insurance ( PDF - 417 KB)
HRSA 508 Borrower Deferment Request (PDF - 56 KB)
HRSA 510 Lender's Application for Insurance Claim (PDF - 368 KB)
HRSA 512 Holder’s Report on Health Education Assistance Loans (PDF - 502 KB)
HRSA 513 Request for Collection Assistance (PDF - 64 KB)
HRSA 539 Physician's Certification of Borrower's Total and Permanent Disability (PDF - 117 KB)

Contact HEAL

1-877-411-4325 (1-877-411-HEAL) weekdays 8:30 am to 5 pm ET, except Federal holidays