Skip to main content
FRAUD ALERT

Be aware of multiple fraudulent text scams requesting payment for NCDMV fees, fines or tolls. NCDMV will NEVER request payment by text. Please report it as spam and delete. Learn More

An official website of the State of North Carolina An official website of NC How you know

State Government websites value user privacy. To learn more, view our full privacy policy.

Secure websites use HTTPS certificates. A lock icon or https:// means you’ve safely connected to the official website.

Utility Menu
  • NCDHHS COVID-19
  • NC.GOV
  • AGENCIES
  • JOBS
Home

Main menu

  • Assistance
    • Assistance
    • ADA and Civil Rights Grievance Procedure
    • Division of Aging
    • Assistive Technology
    • Children's Services
    • Crisis Services
    • Deaf-Blind Services
    • Disability Services
    • Disaster Recovery Health and Safety
    • Guardianship
    • Hearing Loss
    • Low-Income Services
    • Medicaid
    • Mental Health And Substance Use Disorders
    • Mental Health Crisis Services
    • Nondiscrimination and Accessibility Requirements
    • North Carolina Reproductive Health Services
    • Unemployment Services
    • Veteran's Services
    • Vision Loss
    • Vital Records
    • Disaster Preparation
    • Hurricane Dorian Recovery
    • Hurricane Florence Recovery
    • Hurricane Helene Recovery Resources
    • Disaster Preparation and Recovery
  • Divisions
    • Divisions
    • Aging
    • Child and Family Well-Being
    • Child Development And Early Education
    • Disability Determination Services
    • Employment and Independence for People with Disabilities
    • Health Benefits (NC Medicaid)
    • Health Service Regulation
    • Mental Health, Developmental Disabilities and Substance Use Services
    • Office of Economic Opportunity
    • Office of Health Equity
    • Office of Rural Health
    • Public Health
    • Services for the Blind
    • Services for the Deaf and Hard of Hearing (DSDHH)
    • Social Services
    • State Operated Healthcare Facilities
  • Providers
    • Providers
    • Licensure
    • Provider Information
    • LME-MCO Directory
    • Policies, Manuals and Forms
  • News
    • News
    • Press Releases
    • Media Contacts
    • Events
    • Newsletter Articles
    • Follow NCDHHS on Social Media
  • About
    • About
    • Administrative Offices
    • Data Dashboards, Action Plans/White Papers
    • Department Initiatives
    • DHHS Mission, Vision, Values and Goals
    • Directives
    • Grant Opportunities
    • Leadership
    • Overview
    • Priority Goals
  • Contact
    • Contact
    • Division Contacts
    • Hotlines
    • Report Fraud
    • Vendor Resources

Utility Menu

  • NCDHHS COVID-19
  • NC.GOV
  • AGENCIES
  • JOBS
  1. Home

Health Care (Providers)

Document Name
CDS Appointment Representative
CDS Assessmentform
CDS BackgroundCheckPolicy
CDS BackupPOC
CDS ChangeOrderFormFMS2112
CDS EmploymentAgreement
CDS EmploymentApplication2113
CDS FaxCoverSheet SelfDeterminationClients
CDS FISCALAGENTAGREEMENT
CDS HOMECARE INDENROLLMENTFORM4
CDS HOMECARE INDParticipantBILLOFRIGHTS2
CDS HOMECARE INDPersonalAssistantBILLOFRIGHTS2
CDS LetterofInquiryforExtraWork
CDS NCDAAS Self AssessmentForm2113
CDS ParticipantReferralForm FMS2113
CDS PayrollScheduleE
CDS SelfDeterminationEmployeeTimecard
CDS SelfDeterminationTimecardInstructions
DAAS101 Long
Vendor Agreement7 1 15

Contact Information

NC Department of Health and Human Services
2001 Mail Service Center
Raleigh, NC 27699-2000

Customer Service Center: 1-800-662-7030
Visit RelayNC for information about TTY services.

Follow Us

Network Menu

  • Employee Directory
  • nc.gov
  • Website Feedback
  • Accessibility
  • Disclaimer & Terms of Use
  • Privacy Policy
  • Open Budget
Hosted on Digital Commons