Alzheimer and Dementia Kit

Members with cognitive impairments or sensory-related needs who are enrolled in Carolina Complete Health’s Care Management program are eligible to receive a sensory support kit tailored to their developmental and/or diagnostic needs.

Eligibility

Carolina Complete Health members must be 18 years or older and be diagnosed with a neurological impairment. One kit per member per plan year (April 1 - March 31).

ALZHEIMER AND DEMENTIA KIT FORM

Member Name * As it appears on your Carolina Complete Health Member ID card

Member ID Number * As it appears on your Carolina Complete Health Member ID card

Member Date of Birth *

Member Address * Must match address on file with Carolina Complete Health

City *

Zip Code * Must be 5 digits

Member Phone Number *

Member Email Address *