Application Forms
A non-refundable application fee of $300 is required with the submission of an application for review. Should a child be accepted into the Heartlight program, the application fee will be applied to the first month’s tuition.
We will gladly discuss your child’s needs and situation prior to submission of an application. Please fill out our online Inquiry Form as a first step.
Each of the downloadable forms below is an Adobe Acrobat document. If the file doesn’t open, click the Adobe icon to download and install the free Acrobat Reader.
REQUIRED APPLICATION FORMS (click to open or download) Include all three with a recent photo
of your teenager and the $300 payment):1. Admission Application (PDF)
OPTIONAL FORMS (for your information):
Possible Sources of Funding (Loans)
Loans can cover treatment costs, tuition and even transportation to and from the program.
American Healthcare Lending
American HealthCare Lending simplifies the process of paying for your treatment. Working with a national network of specialized lenders, our compassionate loan consultants will help you find the most suitable financing option while maintaining the highest levels of confidentiality. Click the button below to begin the no-obligation application process.













