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Alliance Health - North Carolina

Thank you for making a referral. Please complete the form by clicking the link below. You will be able to upload the intake assessment directly into the form. All submissions are made via HIPAA compliant transmissions. Once the referral is submitted, you will be redirected to an appointment scheduler to pick a date and time for the initial evaluation. Please email: with questions.

You can also support the individual referred (or their conservator) with signing the consent for treatment electronically by sharing the link below. 

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