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.
The Children's Law Clinic has a limited service area. Potential clients must live in one of the following counties: Alamance, Caswell, Chatham, Durham, Granville, Franklin, Orange, Person, Vance, Wake, and Warren.
* Please note, you cannot save an electronic copy of this form with your data filled in.
- Children’s Law Clinic
- Legal Aid of North Carolina
Complete the referral form (.pdf)