About this form

PSC HQ Payment

Attention!  Please read this information before completing the form and submitting a payment.

• Do not use this form if you are paying a FDA debt or Health Education Assistance Loan.
• The payment date schedule has been updated for bank account payments. You will not be able to pick the next business day.

If you are using this form to return HRSA PRF funds and require assistance:

Email: ProviderReliefContact@hrsa.gov

Phone: (866) 569-3522

For other questions, please contact the Program Support Center:

Email: DebtCollectionCenter@psc.hhs.gov

Phone: 800-247-8415

Accepted Payment Methods:

• Bank account (ACH)
• Debit or credit card