FORMS | Welcome to iHEAL

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Patient & Referral Forms

New Appointment Rquest

Use this form to request a new patient appointment. Wait times fluctuate based on the service requested and time of year.

Informed Consent

Our informed consent gives you information about iHEAL services, confidentiality, benefits and risks of treatment, payment options, and agency policies.

PRP Referral Form

Use this form to submit a referral for our Partial Rehabilitation Program. ONLY licensed mental health providers can make a referral.

Release of Information

Give iHEAL permission to send your medical information to another agency or person using this form.

Patient Rights & Responsibilities

Rights and expectations of iHEAL patients can be found in this document.

Professional Disclosures

Please see our professional disclosures for licensed therapists still under supervision.