Patient Resources

Patient Forms

We are committed to supporting your journey towards better mental health and well-being. On this page, you will find essential documents to assist you in managing your care with us. These resources are designed to ensure that your interactions with our services are as smooth and effective as possible.

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

Authorization to Release Confidential Information

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

Consumer Concern Form

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

Request to Correct or Amend Personal Health Information

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

NCS Intake

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

Referral Form