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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. 

    Book Now

    9419 Common Brook Road Suite 208

    Owings Mills, MD 21117

    Tel: (410) 864-0211

    Fax: (410) 618-4163

    info@myiHEAL.com

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    Saturday 9am-4pm

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