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Programs of Care

BGHNC accepts referrals from various sources. We provide both long and short-term care for children and youth.

For more information about admissions and referrals, please contact Chief Residential Officer and Admissions Director Erika Brown. You can email admissions@bghnc.org or call 910-646-3083 or 910-234-6477.

Admissions Criteria

To be eligible for youth program residential admission, a child must:

  • Be between the ages of 6 and 21
  • Be unable to successfully live in his/her family and/or home community or a less restrictive setting
  • Have educational goals he/she is willing to work toward
  • Able to live in a non-secure, non-therapeutic environment without posing a risk to themselves or others

BGHNC offers its services to clients regardless of race, color, religion, sex, sexual orientation, national origin, age, genetic information, disability or any other characteristic protected by law.

The Application for Placement can be completed below and will be emailed to admissions@bghnc.org. Or you can print and complete this Application Form and email it to admissions@bghnc.org.

Boys & Girls Homes Placement Application
Date of Application
Month
/
Day
/
Year
Date Placement is needed:
Month
/
Day
/
Year
Type of Placement Requested:
Reason
Reason for referral (choose one):
What is the current placement time length for the child or children?
Please list number of days, weeks, months and years.
Level of care
Please choose the level of care the child had at their previous placement.
Child's full name:
First Name *
Last Name *
Sex
Child's birth gender:
Child's date of birth:
Month
/
Day
/
Year
Child's current age:
Child's home county:
Child's weight:
Child's height
Child's current address:
Country
Address Line 1 *
City *
State/Province *
Postal Code *
Child's primary language:
Child's Medicaid number:
Please describe the child's distinguishing features.
Name of this child's legal guardian:
First Name *
Last Name *
Name of Assigned Assessment/Foster Care Social Worker
First Name *
Last Name *
Address of Assigned Assessment/Foster Care Social Worker
Country
Address Line 1 *
City *
State/Province *
Postal Code *
Phone number of social worker:
Social worker phone
ext Extension
Name of child's Guardian Ad Litem:
First Name *
Last Name *
Guardian Ad Litem phone number:
Guardian Ad Litem phone
ext Extension
Please list child's current medications:
Please list the child's previous medications:
Medication compliance
Is child compliant with taking his/her meds?
Name of medication provider:
First Name *
Last Name *
Medical concerns/diagnosis/special accommodations:
Referring social worker:
First Name *
Last Name *
Referring social worker phone:
Referring social worker phone
ext Extension
Child's trauma history
Please describe the child's trauma history.
If checked, please describe the nature of the trauma.
Please describe current emotional/behavioral concerns for the child:
Verbal aggression
Is the child verbally aggressive?
Physical aggression
Is the child physically aggressive?
If the child is verbally or physically aggressive, please describe these behaviors.
Previous property damage infractions
Has this child committed property damage?
If the child committed property damage, please describe the incident(s) and whether others were injured in this act.
Were criminal charges filed and what were those charges?
Aggression characterization
This child's aggression could be characterized as:
Targets of aggression
Who are the main targets of the child's aggression?
Place of aggression
Where is the member aggressive?
Describe any known triggers for the child's aggression.
Please describe the most recent episode of aggression.
Please add your additional comments here.

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