For all new referrals*, please use the appropriate referral form listed below, and fax to 919-962-7373, addressing to the attention of ‘OASIS Referrals’. Our referral specialist will contact you within 1 week to conduct pre-screening for program eligibility. If you are a provider, and are unsure about whether to request a consult or make a referral, please read the information on our Consults page.
Inpatient Hospital Providers (Non-UNC providers only)
Internal Referral (from UNC Hospitals/Healthcare providers and their affiliates: Wakebrook, Rex Hospitals, etc.)
- Self or Family Referral
- Release of Medical Information (please use the form if you are an outside provider, and have all previous records sent to the OASIS program at the fax number listed above)
- Consult Referral (for medical providers seeking consultation services)
If you are experiencing a financial hardship surrounding affording the cost of treatment, out staff will provide financial counseling and referrals for assistance on an as needed basis.
*Please note: OASIS is currently accepting new patients.