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Ridley Hall, Suite 114
Phone
: (252) 335-3275
Hours
: 8:30 am - 5:00 pm
Monday - Friday
treatment services application
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First Name
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Classification
Previous Treatment Provider
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Amount Owed
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Amount Requested
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Services Rendered
Please Select
Inpatient admissions
Psychiatric Services, including initial evaluation and continuous management
Outpatient Clinical Services (e.g., trauma therapy, EMDR)
Detox and Substance Abuse Treatment
Eating Disorder treatment clinics, including inpatient services.
Payment of copays and deductible related to mental health treatment
Medication purchase
Psychological testing
Ambulatory services
Other Specialized Mental Health Care
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