Attend|Behavior Interest Form

Attend|Behavior Interest Form

The North Carolina Division of Mental Health, Developmental Disabilities and Substance Use Services (DMHDDSUS), in collaboration with Trillium Health Resources, has partnered with Attend Behavior to deliver innovative, technology-enabled caregiver support across 46 counties. This initiative will bring immediate, virtual access to evidence-based family guidance and parent training for families of children with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), and Intellectual and Developmental Disabilities (I/DD).

The Attend Behavior platform ensures that families can begin receiving support immediately—whether they are waiting for a diagnosis, formal services, or navigating day-to-day behavioral challenges. Please fill out the interest form below to get started with Attend at no cost to you.

Child's Information

Child's First Name*

Child's Last Name*

Child's Date of Birth*

Insurance Information

Insurance Provider*

County of Residence*

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Parent/Guardian Information

First Name*

Last Name*

Email Address*

Phone Number*

Phone

Relationship to Child*

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Communication from Attend*

Attend Behavior is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please indicate this using the dropdown below.

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By clicking submit below, you consent to allow Attend Behavior to store and process the personal information submitted above to provide you the content requested.

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