RESOURCES | ADCNC

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NC NATIONAL GUARD
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RESOURCES

PROVIDER INSTRUCTIONS

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Request help anytime. Complete the questions below and we will follow up with you.

First Name

Is this request for help for you or someone else?

Phone

Email

How did you hear about us?

Zip Code

These next few questions are for the person needing help:

Race

Age

Gender

Do you have insurance? If yes, which provider?

Are you seeking help for Mental Health or Substance Use?

If Substance Use, what substances are being used?

Do you have a safe place to live?

Your request for help has been submitted to our team.

Someone from our team will contact you to follow up.

HOME
ABOUT US
PERINATAL
NC NATIONAL GUARD
RESOURCES
OUR EVENT PAGE
More

Use tab to navigate through the menu items.

We Care.

Let's Connect.

1.800.688.4232

© 2022 Alcohol / Drug Council of North Carolina

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