GHA Application for Services Revised 8-26-2024How to Access Our Services
GHA provides a variety of Medicaid and Innovations Waiver funded supports to children and adults with a primary diagnosis of autism spectrum disorder who reside in the state of North Carolina.
If you are interested in consideration for potential services, please submit a completed Application for Services.
If you would like to have further discussion regarding GHA Autism Supports and the services that are provided to support individuals with autism spectrum disorder, or any other questions regarding the referral and application process, please contact our Admissions and Referrals line at 704-982-9600 ext. 200 or email us at GHAAdmissions@ghainc.org.
Please note: GHA Autism Supports is a restraint-free organization, and we are unable to offer placement to individuals requiring the use of restrictive interventions.
Please click on the following link to download our standard application for services.
GHA Application for Services Revised 8-26-2024or Solicitud de Servicios APP 8-26-2024
Read this HIPAA security warning prior to emailing any information. This includes the “Electronically scan” option below. Keep in mind that communications via email, including attachments/scans, over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed.
a. Complete in entirety and mail to GHA Autism Supports, P.O. Box 2487, Albemarle, NC 28002
b. Electronically scan to GHAAdmissions@ghainc.org
c. Fax the completed application to (980) 443-5089
OR,
If you have questions regarding GHA’s referrals and admissions process or if you would like more information regarding the services/supports offered by GHA, please call GHA’s Admissions and Referrals Line at (704) 982-9600 ext. 200. To receive a hard copy of the Application for Services or to receive a hard copy in a preferred language, please contact the Admissions and Referrals Line at (704) 982-9600 ext. 200, or by email at GHAAdmissions@ghainc.org.
Contact Us
Physical Address:
213 N. Second Street, Albemarle, NC 28001
Mailing Address:
PO Box 2487, Albemarle, NC 28002
Wilmington Office:
PO Box 4122, Wilmington, NC 28406
Phone: (704) 982-9600
Fax: (704) 982-8155
Wilmington:
Phone: (910) 769-1046
Fax: (910) 399-1780
GHA Autism Supports is licensed by the Division of Health Service Regulation of the North Carolina Department of Human Resources. In addition, GHA Autism Supports is nationally accredited by Commission on Accreditation of Rehabilitation Facilities (CARF). ICF/IID homes are certified by the North Carolina Division of Medical Assistance. GHA Autism Supports is a member of the North Carolina Association of Community-Based ICF/IID and CAP providers and the North Carolina Providers Council.
In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, age, disability, religion, sex, familial status, sexual orientation, and reprisal. (Not all prohibited bases apply to all programs).