Speed Referrals

Please use these forms only if you are familiar with these programs and their eligibility criteria. If you are not sure about this, please call our Information Department at 919-713-1556 to discuss your needs.


Complete referral forms online and submit electronically for:


Please be sure to complete all of the boxes on the form -- We cannot accept referrals with missing information.

Please note: If you experience difficulty using these forms, including getting an error message instead of a confirmation that your referral was sent, please call us at 919-713-1556 and let us know.