Feb192026
Guardianship Q&A Series

What medical records do I need to file for guardianship, and how can I get them legally? – North Carolina

Short Answer

In North Carolina adult guardianship cases, there is usually no single “required set” of medical records that must be attached to the initial filing. Instead, the petition must explain facts showing why the adult may be incompetent, and the Clerk of Superior Court can order a confidential evaluation if medical information is needed. Medical records generally cannot be obtained by a family member without the adult’s written authorization or legal authority (such as a health care power of attorney or a court-appointed guardianship), but the court process can create a lawful path to get the information needed.

Understanding the Problem

In North Carolina, a family member seeking guardianship for an adult relative often needs medical information to show that the adult cannot manage important decisions. The practical problem is that health care providers usually will not release records to a relative without legal authority, even when the relative is trying to start a guardianship case. The single decision point is whether enough medical information can be gathered legally to support an incompetency/guardianship filing and to move the case forward in front of the Clerk of Superior Court.

Apply the Law

North Carolina guardianship for an adult typically starts with an incompetency proceeding before the Clerk of Superior Court. The law focuses on what must be alleged in the petition and what evidence the clerk may require, rather than requiring a specific packet of medical records to be filed at the outset. If the clerk decides more information is needed about the adult’s condition and functioning, the clerk can order a multidisciplinary evaluation, which is filed with the clerk and treated as confidential (not a public record) and released only as the clerk directs.

Key Requirements

  • Facts showing possible incompetence: The filing must include a clear, plain statement of facts that tend to show the adult cannot manage important affairs or make/communicate important decisions.
  • Financial picture and why guardianship is needed: The filing should include a general description of assets, liabilities, and the reason guardianship is being sought (for example, authority to arrange and pay for safer living arrangements).
  • Less restrictive alternatives considered: The filing must identify alternatives considered (like powers of attorney or supported decision-making) and explain why they are not enough for the situation.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, the goal is appointment as guardian for an adult relative, but medical records are not accessible yet and the process feels time-consuming. North Carolina law does not require attaching a full medical chart to start the case; it requires a verified petition stating facts that tend to show incompetence and describing assets and needs, including the need to use funds for improved living arrangements. If the clerk needs more clinical information than the petition can provide, the clerk can order a confidential multidisciplinary evaluation to help the court decide the nature and extent of any disability and what type of guardianship (including limited guardianship) may be appropriate.

Process & Timing

  1. Who files: The person seeking appointment (often a family member). Where: The Office of the Clerk of Superior Court in the county where the adult resides in North Carolina. What: A verified petition to adjudicate incompetence and (often) an application to appoint a guardian. When: Filed as soon as practical once the need for decision-making authority is clear, especially if housing, safety, or bill-payment decisions are pending.
  2. How medical information gets into the case legally: If the adult can sign a HIPAA-compliant authorization, providers can release records directly to the requester. If the adult cannot or will not sign, the case can still proceed based on observed facts and other non-record evidence, and the clerk can order a multidisciplinary evaluation under North Carolina law. The evaluation is filed with the clerk and handled as confidential.
  3. After appointment: Once a guardian is appointed, the guardian’s authority depends on the type of guardianship ordered (person, estate, or general). For financial goals like paying for improved living arrangements, the authority typically comes from being appointed guardian of the estate (or general guardian), and the clerk’s orders and ongoing court supervision may control how funds are accessed and used.

Exceptions & Pitfalls

  • Assuming “family” status equals access: A close relationship does not automatically allow access to medical records. Without a signed authorization or recognized legal authority, providers commonly refuse disclosure.
  • Over-focusing on records instead of function: Guardianship decisions are about the adult’s ability to manage affairs and make/communicate decisions. Practical, specific examples of unsafe choices, missed bills, inability to arrange care, or inability to understand consequences often matter as much as diagnoses.
  • Skipping less restrictive alternatives: North Carolina requires the petition to address alternatives and why they are insufficient. If a valid power of attorney or other tool exists, the clerk may question whether guardianship is necessary or whether a limited guardianship would meet the need.
  • Trying to use the adult’s money before authority exists: Paying for new living arrangements with the adult’s funds before appointment can create conflict and scrutiny. The safer path is to seek the appropriate appointment and follow the clerk’s directions about access and expenditures.
  • Privacy and filing mistakes: Even when medical documents are obtained, they should not be filed casually or broadly shared. Court-ordered evaluations are treated as confidential and released only as the clerk directs.

For additional North Carolina-specific context, see can’t access their medical records and what paperwork and medical records in adult guardianship cases.

Conclusion

In North Carolina, an adult guardianship case usually does not require filing a full set of medical records with the initial petition. The petition must state facts supporting incompetence, describe assets and needs, and explain why less restrictive options are not enough. If medical information is needed, the Clerk of Superior Court can order a confidential multidisciplinary evaluation. The next step is to file a verified incompetency petition with the Clerk of Superior Court in the adult’s county of residence and request an evaluation if the case cannot be proven without it.

Talk to a Guardianship Attorney

If a family member is seeking adult guardianship but medical records are not accessible and financial decisions (like paying for safer living arrangements) cannot wait, our firm has experienced attorneys who can help explain options, paperwork, and timelines. Call us today at [919-341-7055].

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.