Member Document Library
Attention members and guardians - Docusign
Based on your feedback, we are now using DocuSign - a safe and trusted way to collect electronic signatures with no account required. We will now be able to email or text you a link to forms for your signature. If you have any questions, please speak with your Care Manager or the care coordinator who contacted you about the documents.
- Access Point Rack Cards
- Accessing Care Brochure
- CIT Brochure
- CFAC Brochure
- EPSDT brochure
- HOP Brochure
- Individual & Family-Directed Supports Brochure
- Intellectual Developmental Disability (I/DD) Services Array Brochure
- Mental Health First Aid Brochure
- Member Appeals Brochure
- NEMT brochure.
- Quit for Life Brochure.
- Tailored Care Management Brochure
- Weathering the Storm Pamphlet
- Member Grievances Brochure
- Recognizing Warning Signs of Alcohol or Other Drug Use in Adult
- Recognizing Warning Signs of Alcohol or Other Drug Use in Teen
- Trillium Choose Independence Application Form
- Trillium Human Rights Committee Application Form
- Trillium Health Equity Council Application
- Trillium Registry of Unmet Needs” (RUN) application
- Child with Complex Needs Referral Form
- Consent for Release of Member Information
- Consent for Release of Member Information (Español)
For Tailored Plan Medicaid Members
- TCM change request form
- Stop Getting TCM
- PCP change request form
- Member and Recipient Portal Requests
- Check Claim Status
- Appeals Submission Form
For NC Medicaid Direct
- TCM Change Request Form
- Stop Getting TCM
- Member and Recipient Portal Requests
- Check Claim Status
- Appeals Submission Form
For State-funded Recipients
- 2023 Annual Report
- 2023-2024 Cultural Competency Plan
- 2023-2024 DEI Report
- Agency with Choice & Employer of Record - Individual & Family-Directed Supports
- Agency with Choices Handbook Supplement
- Do you need Respite?
- Employer of Record Handbook Supplement - Individual & Family-Directed Supports
- Employer Resources & Forms Handbook - Individual & Family-Directed Supports
- Fact Sheet Community Navigator
- Fact Sheet-Duties of Representative
- Fact Sheet-Individual Goods and Services
- Fact Sheet-Overview Individual & Family Supports
- Health Equity Report
- HOP Member Rights and Responsibilities
- HOP Services Definitions
- How can I have a Healthier Lifestyle?
- How do I get Private Duty Nursing?
- Hurricane Season Readiness
- Hypertension: High blood pressure
- NC Help Line for Children & Youth with Special health Care Needs
- NC Medicaid NEMT Flyer
- Notice of Privacy Practices/ Member Rights & Responsibilities
- Quit for Life Flier.
- Road2Ready Providers Toolkit
- Trillium Beneficiary Responsibilities NC Innovations
- What if your provider is Out of Network (OON)?
- What is Asthma?
- What is Diabetes?
- What is Medicaid Direct?
Page last verified on