CareNet Counseling Center
910-799-1071

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    • Wilmington
    • Jacksonville
    • Shallotte
    • Bolivia
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New Client Forms

In order to expedite the registration process and get you started with your counselor right away simply:

  • Print, complete, and bring each of the forms below to your appointment.
  • Arrive a few minutes early for your appointment in order for your paperwork to be processed.
  • Bring your picture ID and your insurance card
  • Bring a list of your medications
Also, please note that if you are coming with someone (i.e. couple or family) ONLY the primary client needs to fill out this paperwork.

Be advised that a copy of our Privacy Practices can be found in a blue binder in our main waiting room which you are welcome to read at your convenience. The form below regarding Privacy Practices is an acknowledgment that you have been given access to this document.
Confidential Information Form
Consent to Treatment
Privacy Practice
Medical History
Client Rights
CareNet Counseling Centers of southeastern North Carolina are associated with Wake Forest Baptist Health
Wilmington (Main Office) 
at Wilmington Baptist Assoc.
610 S. College Rd
Wilmington, NC 28403
910-799-1071
Wilmington (Satellite)
at Harbor United Methodist
4853 Masonboro Loop Rd.
Wilmington, NC 28409
910-799-1071
Jacksonville
at New River Baptist Assoc.
2734 Commerce Rd.
Jacksonville, NC 28546
910-799-1071
Wilmington CareNet
About US
Our Counselors
Our Staff
Locations
Bolivia
at Brunswick Baptist Resource Center
1041 Old Ocean Hwy
Bolivia, NC 28472
910-799-1071
Shallotte
at Brunswick Family Medical
712 Village Rd SW, Ste 104
Shallotte, NC 28470
910-799-1071
Executive Board
History
Frequently Asked Questions
Donations and Support
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