Posted Date: October 21, 2014

Author:  Pamela Eliadis, Service Director, System Operations & Aid Delivery Management, Federal Student Aid

Subject: HEAL Program Information - ED HEAL Program Forms Now Available for HEAL Lenders and Lender Servicers to Use

As explained in a July 2, 2014 Electronic Announcement posted on the Information for Financial Aid Professionals (IFAP) Web site, the Health Education Assistance Loan (HEAL) Program was transferred from the U.S. Department of Health and Human Services (HHS) to the U.S. Department of Education (ED) on July 1, 2014, as required by the Consolidated Appropriations Act, 2014 (Pub. L. 113-76). ED is now responsible for managing the servicing of non-defaulted HEAL Program loans and the collection of defaulted HEAL Program loans.

In the July 2nd announcement, we informed HEAL Program lenders and lender servicers that we had transferred the Office of Management and Budget (OMB) clearance of HEAL Program forms from HHS to ED and that we were in the process of updating the OMB clearance information on each form and replacing HHS references and contact information with ED’s information. We also explained that we would post the updated versions of the forms on the HEAL Forms page of the HEAL Program Area on IFAP and inform lenders and lender servicers of their availability.

The ED versions of nine out of ten HEAL Program forms are now available on the HEAL Forms page. Previously, HEAL Program lenders and lender servicers were to use the HHS versions of the forms until the ED versions became available. Now that the ED versions have been posted, lenders and lender servicers should begin using the new forms.

The table below lists the OMB number, name, and HEAL number associated with each form.

OMB Number

Form Name

HEAL Form Number


Borrower Deferment Request



Physician’s Certification of Borrower’s Total and Permanent Disability



Repayment Schedule (Variable Rate)



Repayment Schedule (Fixed Rate)



Lender’s Application for Contract of Federal Loan Insurance



Lender’s Application for Insurance Claim



Instructions for Lender’s Application for Insurance Claim

Not Applicable


Request for Collection Assistance



Holder’s Report on Health Education Assistance Loans


Note: There is not yet an ED version of the Medical Release form. Until we provide an ED-cleared version of the form, HEAL lenders and lender servicers should continue to use the HHS version of the Medical Release form.

Contact Information

If you are a HEAL Program lender or lender servicer and have questions about the HEAL Program forms, contact the HEAL Program Team at 844/509-8957 or

Complete contact information for the HEAL Program is available on two IFAP Contact Information pages.

Thank you for directing HEAL Program inquiries as outlined on the Contact Information pages.


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