How to Access Our Services

Please click on the following link to download our application for services.
PDF Application For Services  or Solicitud de Servicios


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
c.      Fax the completed application to 704-982-8155.



If you have questions regarding GHA’s referrals and admissions process, please call GHA’s Admissions and Referrals Line at (704) 982-9600 ext. 200.

To receive a hard copy of the Application for Services, please contact the Admissions and Referrals Line at (704) 982-9600 ext. 200, or by email at

If you have additional questions, or would like to learn more information regarding the services/supports offered by GHA, please contact Jennifer Rorie-Bruton, at (704) 982-9600, ext. 124, or by email at

Please contact the Quality Management Department to obtain an application for services in a preferred language.