Feb182026
Guardianship Q&A Series

How do I become a legal guardian for an adult relative when I can’t access their medical records? – North Carolina

Short Answer

In North Carolina, an adult guardianship usually starts with an incompetency case filed with the Clerk of Superior Court in the county where the adult lives. Not having medical records does not automatically stop the case, because the clerk can consider other evidence of incapacity and may order an evaluation if needed. Once the clerk adjudicates the adult incompetent, the clerk can appoint a guardian (often a limited guardian) and issue “letters” that give legal authority to access information and manage money within the scope of the appointment.

Understanding the Problem

In North Carolina, can a family member become a legal guardian for an adult relative when health providers will not release medical records, and the goal is to get authority to arrange safer living conditions and pay for them using the relative’s funds? The decision point is whether to move forward with a court guardianship case even without records in hand, knowing the process can feel time-consuming and formal. The core issue is getting the court to grant legal authority to act, when the relative cannot or will not sign releases and the family member needs a lawful way to access information and handle finances.

Apply the Law

North Carolina adult guardianship typically involves two connected steps handled by the Clerk of Superior Court: (1) an incompetency proceeding to determine whether the adult meets the legal definition of “incompetent,” and (2) an appointment proceeding to decide whether a guardian is needed, what type (person, estate, or both), and who should serve. The petition must explain why guardianship is needed and what less restrictive options were considered first. If the evidence is not current or is incomplete, the clerk has tools to require additional evaluation before deciding what authority (if any) to grant.

Key Requirements

  • File the right case in the right place: The incompetency petition is filed with the Clerk of Superior Court, generally in the county where the adult (the “respondent”) resides.
  • Show why guardianship is needed (and why alternatives are not enough): The petition must describe facts that support incompetency and identify less restrictive alternatives that were considered (for example, powers of attorney or other supports) and why they are insufficient.
  • Match the requested authority to the need: The clerk can tailor the appointment (including limited guardianship) based on the adult’s abilities and the specific decisions that need to be made, such as housing/placement and paying bills.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, the goal is to obtain legal authority to improve an adult relative’s living arrangements and to use the relative’s money to pay for those arrangements. The inability to access medical records is common when the adult cannot sign releases or providers will not disclose information without legal authority. Under North Carolina’s process, the case can still be filed with the clerk, and the petition can explain the functional problems being seen (for example, inability to manage money safely or understand housing decisions) and why less restrictive options are not workable right now.

Process & Timing

  1. Who files: Any person with a legitimate concern can file the verified incompetency petition, and a proposed guardian can file an application for appointment. Where: Clerk of Superior Court in the county where the adult relative resides in North Carolina. What: A verified petition for adjudication of incompetence and an application for appointment of guardian (the clerk’s office typically provides local forms and filing instructions). When: As soon as a decision is made that the adult cannot manage essential decisions and delay risks harm, missed bills, unsafe housing, or exploitation.
  2. Evidence and evaluation: If medical records are unavailable or not current, the case can focus on observable functional limitations and third-party information (caregiver observations, facility concerns, prior diagnoses known to the family, and other documentation). If the clerk decides more clinical information is necessary, the clerk can require an evaluation before deciding the scope of guardianship.
  3. Appointment and authority: If the clerk adjudicates the adult incompetent and appoints a guardian, the clerk issues letters of guardianship. Those letters are typically what banks, landlords, and health providers look for before recognizing authority to manage funds, arrange placement, and request information within the guardian’s legal role.

Exceptions & Pitfalls

  • Skipping “less restrictive alternatives”: North Carolina petitions must address what alternatives were considered and why they do not work. A petition that does not clearly explain this can stall the case or lead to a narrower order than expected.
  • Assuming guardianship automatically grants unlimited power: The clerk can order limited guardianship. If the main need is paying for housing and services, the request should be tailored to those decisions (for example, authority over finances and placement) rather than asking for broader powers than necessary.
  • Trying to use the relative’s money before appointment: Without legal authority, using the adult’s funds can create conflict with other family members, trigger bank refusal, or raise concerns about exploitation. The safer path is to seek court authority first and keep careful records once appointed.
  • Medical-record roadblocks: Providers often require a valid HIPAA authorization signed by the patient or a legally recognized decision-maker. Until the clerk appoints a guardian (or another valid authority exists), records may remain unavailable; the case should be built around functional evidence and the clerk’s ability to require evaluation if needed.

For more detail on the kinds of documentation and evaluations that often come up in these cases, see what paperwork and medical records do we need to prove incapacity and whether a new evaluation or recent medical records are needed.

Conclusion

In North Carolina, an adult guardianship generally requires filing an incompetency petition with the Clerk of Superior Court and then seeking appointment as guardian (often tailored as a limited guardianship). Lack of access to medical records does not automatically prevent filing, because the clerk can consider other evidence and can require an evaluation if needed. The practical next step is to file a verified incompetency petition with the clerk in the county where the adult lives and clearly explain the functional problems, the need for authority over money and living arrangements, and why less restrictive options are not sufficient.

Talk to a Guardianship Attorney

If a family member needs a guardian but medical records are hard to obtain and decisions about housing and finances cannot wait, our firm has experienced attorneys who can help explain the North Carolina process, what evidence to gather, and what timelines to expect. Call us today at [CONTACT NUMBER].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

Category: Guardianship Q&A Series

Author: Pierce Law

Pierce Law Group is a North Carolina law firm focused on probate administration, real estate partition matters, and surplus funds claims across North Carolina. We know these situations often come with stress, family dynamics, and time-sensitive decisions—so we prioritize clear communication, steady guidance, and a practical plan from day one. Our goal is to make a complicated process feel manageable, while protecting what matters most to you.