Referrals
Medical providers: Please use this form to refer a patient to the Medical-Legal Partnership. The form may be filled in, printed, and then faxed to the Duke Law Children's Clinic or to Legal Aid of North Carolina.
* Please note, you cannot save an electronic copy of this form with your data filled in.
- Children’s Law Clinic
fax: 919-613-7262 - Legal Aid of North Carolina
fax: 919-682-8157
Complete the referral form (.pdf)
