Become a Member

New Member Forms For Download

Referral Packet

Authorization Forms

Eligibility:

  • An individual must have a major mental illness such as schizophrenia, bipolar disorder, schizoaffective disorder, or major depression.
  • An individual’s principle and/or primary diagnosis cannot be developmental disability, dementia, a substance abuse disorder, or personality disorder.
  • An individual must be at least 18 years of age.
  • An individual must be a resident of Orange, Person or Chatham County.
  • An individual must not be a current risk for or have a significant history of harm to self or others.
  • An individual should not currently receive Assertive Community Treatment Team (ACTT) services.

If you meet the above criteria and are interested in becoming a member:

  • Call Peter Mazzei of the Membership Services Unit at (919) 968-6682 ext. 121 to schedule an informal tour.
  • Get referral packet (see above) completed by a medical professional/social worker.
  • Drop the completed form at the Clubhouse or fax to:

(919) 968-2522 (Attn: Membership).

  • After the referral form is reviewed, you will be contacted by phone by the Membership Unit to arrange a formal orientation.

 

Peter Mazzei of the Membership Unit can answer any questions you may have regarding membership criteria, our services or the referral process. You can reach him or the Membership Unit at (919) 968-6682, ext. 111 or email him at memberrecords@clubnova.org.