Referral Intake Form

Covenant accepts referrals for people with intellectual and developmental disabilities (IDD) and traumatic brain injuries (TBI) across North Carolina. Care managers, families, and anyone supporting a person can start one here.

The form is secure, you can upload documents as you go, and you do not need an account.

What to have ready

You can send the referral without these and follow up later, but it moves faster with them.

• A psychological evaluation listing DSM codes
• A SIS assessment or a 1915(i) assessment
• Guardianship papers, if applicable — a birth certificate for anyone under 18

What happens next

1. Initial review. Our intake team reviews what you have sent and checks which documents are still needed.
2. Contact and scheduling. A member of our team reaches out within 3–5 business days to arrange a welcome meeting, go through the consent forms, and talk through the services available.
3. Information gathering. Once your documents arrive, our clinical team reviews them. We then send the consent forms for signature before the ISP is set up with your care manager.

If you are requesting residential services, please note there is a 30-day processing period.