Skip to main content
An official website of the State of North Carolina An official website of NC

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 Translation Disclaimer
Home

Main menu

  • Assistance
    • Assistance
    • ADA and Civil Rights Grievance Procedure
    • Division of Aging Assistance
    • Assistive Technology
    • Children's Services
    • Crisis Services
    • Deaf-Blind Services
    • Disability Services
    • Guardianship
    • Hearing Loss
    • Low-Income Services
    • Medicaid
    • Assistance with Mental Health, Developmental Disabilities, Substance Use and Traumatic Brain Injury
    • Mental Health Crisis Services
    • Nondiscrimination and Accessibility Requirements
    • North Carolina Reproductive Health Services
    • Unemployment Services
    • Veteran's Services
    • Vision Loss
    • Vital Records
    • 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 Minority Health and Health Disparities
    • 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
    • Child Care
    • Health Care
    • Licensure
    • LME-MCO Directory
    • Mental Health, Development Disabilities, Substance Use Services and Traumatic Brain Injuries
    • Policies, Manuals and Forms
  • News
    • News
    • Press Releases
    • 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
    • Federal Government Shutdown
    • Grant Opportunities
    • Leadership
    • Overview
    • Strategic Plan
  • Contact
    • Contact
    • Division Contacts
    • Hotlines
    • Mail Services for NCDHHS Headquarters
    • Report Fraud
    • Vendor Resources

Utility Menu

  • NCDHHS Translation Disclaimer
  1. Home

NCATP PDF Fillable Referral Form 1 31 2020 (pdf)

NCATP PDF Fillable Referral Form 1-21-2026.pdf

PDF • 299.87 KB - January 21, 2026
NCDHHS logo - white

© 2026 The State of North Carolina. All rights reserved.

Contact Information

Physical Address
1915 Health Services Way 
Raleigh, NC 27607

Mailing Addresses 

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