Patient Resources
Find the forms you need to get started or manage your care with North Carolina Solutions. If you are unsure which form to use, call us at (910) 313-3232. We’re happy to help.
Intake Questionnaire
Please complete this questionnaire before a scheduled assessment. It may be filled out by the person seeking services or, when appropriate, a parent, legal guardian, or authorized caregiver. Our team will let you know what information is needed.
Make a Referral
Use this form to refer someone for one-on-one ABA services or a psychological evaluation or assessment. Our team will follow up to discuss availability and next steps.
If you need to allow someone else to access your health records.
Send completed forms to [email protected] or via U.S. Mail to the following address:
North Carolina Solutions
3904 Oleander Dr STE 102
Wilmington, NC 28403
To address any issues or concerns regarding your experience with our services.
Send completed forms to [email protected] or via U.S. Mail to the following address:
North Carolina Solutions
3904 Oleander Dr STE 102
Wilmington, NC 28403
If there is a need to correct or amend any personal health information we have on file.
Send completed forms to [email protected] or via U.S. Mail to the following address:
North Carolina Solutions
3904 Oleander Dr STE 102
Wilmington, NC 28403
The following questionnaire is to be completed by the child’s parent or legal guardian, and turned in
before a scheduled assessment.
Send completed forms to [email protected] or via U.S. Mail to the following address:
North Carolina Solutions
3904 Oleander Dr STE 102
Wilmington, NC 28403
To make a patient referral, please use this form.
Send completed forms to [email protected] or via U.S. Mail to the following address:
North Carolina Solutions
3904 Oleander Dr STE 102
Wilmington, NC 28403