Building on the ongoing successes of the NC Child and Family Improvement Initiative, and with stakeholder feedback from a sample of residential providers, the LME/MCOs have created a standardized, statewide referral form (some providers may call it an application) for use by all Residential Providers and Therapeutic Foster Care (TFC) providers who contract with them. This standardized form will streamline the referral and evaluation process and support the timely identification of appropriate therapeutic placements for children and youth in North Carolina. Click here to read more.

The standardized referral form is available in the links below:

Both fillable PDF and fillable MS Word versions are available.