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Forms
NC-SNAP: North Carolina Summary Report
and Supplemental Information (Word) June 2010
An original NC-SNAP assessment form must be used to complete all NC-SNAP assessments (i.e., the NC-SNAP assessment form is copyrighted and cannot be independently reproduced).
NC-SNAP Assessment forms can be obtained free of charge from the North Carolina Local Management Entity (LME) (i.e., the local mental health agency responsible for the individual being assessed).
All completed NC-SNAP assessments MUST be returned to the LME for keying into the NC-SNAP database.
All completed NC-SNAP assessments MUST be accompanied by an NC-SNAP Supplemental Information Sheet. This sheet can be independently reproduced and is available by clicking on the link provided.
For a current list of LME contacts responsible for form distribution, contact the LME’s provider relations department, or email the NC-SNAP director at Sandy Ellsworth.
