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Educational Support


At Carolina Complete Health, we believe that true health includes how a child lives, laughs, learns, and plays.

That's why Carolina Complete Health members enrolled in grades K to 6 can get up to $75 for online tutoring or a backpack with school supplies. To get this Valued-Added Service, please complete the form below. A legal guardian must complete form on behalf of member.

Eligibility Statement: Eligibility requirements apply. One voucher per child per year. Grades K to 6. Must complete separate form for each child.

Note: Please allow a minimum of 14 days for review and processing of your request.  If you need immediate support, please call us at 1-833-552-3876 (TTY 711).

EDUCATIONAL SUPPORT FORM

Choose which Educational Support you want
Subject Area(s) requiring Tutorial Services (Select All That Apply) required *
I am the legal parent or guardian for this member, authorized to make decisions on their behalf through Carolina Complete Health
I am requesting online tutoring services on behalf of the member
I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this Agreement. required *

Consent of Electronic Signature

In an effort to make it easier and faster for members to receive online tutoring services,  we are requesting that this Consent Form be completed using an “electronic” signature by entering your name in the box below.  Only the “signature” for the legal parent or guardian of the member that Carolina Complete Health has on file will be accepted on this Consent Form.  A signed Consent Form is required for the member to receive online tutoring services.

If you do not wish to complete this online form with the electronic signature option, you may print out, sign and mail back to us. Please note this process takes longer and will delay your use of this service. Please click here to access this printable form (PDF).

Pick a backpack grade
Pick a backpack color
Pick a backpack color
Pick a backpack color

If you need assistance filling out this form, please call Member Services at 1-833-552-3876 (TTY 711).