Contact Brain Injury Support Services If you would like to learn more about the program, please fill in the fields below and click Submit. Someone will contact you soon! Online Inquiry- Brain Injury Support Services Name* Email* PhoneI am* An adult with a brain injury who would like to learn more about the Brain Injury Support Services program. he parent or legal guardian of someone with a brain injury who would like to learn more about the Brain Injury Support Services program. A medical professional who is interested in referring someone to the Brain Injury Support Services program but would like to learn more. An employee at a human services agency who is interested in referring someone to the Brain Injury Support Services program but would like to learn more. Which Brain Injury Support Services Program Applies to You?* I live in WAKE COUNTY I live in PITT COUNTY I live in FORSYTH COUNTY I live in MECKLENBURG COUNTY Additional Comments Δ