Parent Portal 
Intake Forms
Intake Forms
Required Documents
Referral Form for Medical Providers to Complete
DOWNLOAD CCABA REFERRAL FORM & TRICARE REFERRAL FORM
• The CCABA Service Order/Referral form must be completed in its entirety and signed by a Medical Doctor (MD), Psychologist (PhD), or Psychiatrist (PsyD) only. Commercial insurance companies and NC Medicaid will only accept signatures on these forms from providers with the forementioned credentials.
• Tricare clients must have both the CCABA Service Order/Referral Form AND the Tricare DSM-V Checklist signed, to move forward in the intake process.
• Families using insurance providers NOT including Tricare only have to complete the CCABA Service Order/Referral Form.
Parent Resources
1. Intake Roadmap
2. Caregiver Responsibilities and Expectations
3. Introduction to Services