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NC Division of Health Service Regulation

Mental Health Licensure and Certification Section

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Forms and Applications

The following applications and forms are for use by mental health facilities and those seeking an initial license.

• Instructions for Completing the Initial Licensure Application
• Mental Health Initial Licensure Packet (PDF, 289 KB)
• Mental Health Licensure Change Application (PDF, 120 KB)
• Critical Incident & Death Report Form (Community MH Facilities) (PDF, 139 KB)
• Death Report Form to DHHS (PDF, 39 KB)

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This page was last modified on July 30, 2008.

Division of Health Service Regulation