info@palmettofamilyworks.com | 1-888-255-9365
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Make an Appointment: info@palmettofamilyworks.com | 1-888-255-9365
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  • Our Team
    • Amy Rush, MS, LPC
    • Anna Townsend Stone, MS, LPC
    • April Robinson, MA, LPCA
    • Beth Graham, MS, LPC
    • Caroline Bishop, MA, LPCA
    • Jenny Eastin, LISW-CP
    • Jennifer Elkins, EdD, LPCS, RPTS
    • Kaycee Carter, LISW-CP
    • Lexi Roberts, MA, LPCA
    • Lucy Henry, EdS, LPC, CEAP
    • Lucy Pollard, EdS, LPCA
    • Misty Williams, MS, LPC
    • Reena Freeman, PsyD, Licensed Psychologist
    • Trisha McIntyre Brown, MA, LPC
  • Services
    • ADD/ADHD Counseling
    • Anger Management
    • Autism
    • Cognitive Behavioral Therapy
    • Counseling for Anxiety
    • Counseling for New Mothers
    • Counseling for Trauma
    • Family Counseling
    • Grief & Bereavement Counseling
    • Individual Therapy
    • LGBTQIA+ Individual Therapy
    • Life Transitions
    • Mindfulness-Based Therapy
    • Obsessive Compulsive Disorder (OCD) Counseling
    • Play Therapy
    • PTSD
    • Social Anxiety Disorder Counseling
    • Therapy for Depression
    • Women’s Issues
  • Getting Started
    • FAQs
    • Rates and Insurance
    • Client Forms
    • Appointment Request
  • Resources
    • Careers
    • Upcoming Training
    • Mental Health Links
    • Physical Health Links
  • Contact
    • Florence Location
    • Mauldin Location
    • Lake City Location
  • Blog
  • Appointment Check In
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1-888-255-9365 | info@palmettofamilyworks.com

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  • Home
  • Our Team
    • Amy Rush, MS, LPC
    • Anna Townsend Stone, MS, LPC
    • April Robinson, MA, LPCA
    • Beth Graham, MS, LPC
    • Caroline Bishop, MA, LPCA
    • Jenny Eastin, LISW-CP
    • Jennifer Elkins, EdD, LPCS, RPTS
    • Kaycee Carter, LISW-CP
    • Lexi Roberts, MA, LPCA
    • Lucy Henry, EdS, LPC, CEAP
    • Lucy Pollard, EdS, LPCA
    • Misty Williams, MS, LPC
    • Reena Freeman, PsyD, Licensed Psychologist
    • Trisha McIntyre Brown, MA, LPC
  • Services
    • ADD/ADHD Counseling
    • Anger Management
    • Autism
    • Cognitive Behavioral Therapy
    • Counseling for Anxiety
    • Counseling for New Mothers
    • Counseling for Trauma
    • Family Counseling
    • Grief & Bereavement Counseling
    • Individual Therapy
    • LGBTQIA+ Individual Therapy
    • Life Transitions
    • Mindfulness-Based Therapy
    • Obsessive Compulsive Disorder (OCD) Counseling
    • Play Therapy
    • PTSD
    • Social Anxiety Disorder Counseling
    • Therapy for Depression
    • Women’s Issues
  • Getting Started
    • FAQs
    • Rates and Insurance
    • Client Forms
    • Appointment Request
  • Resources
    • Careers
    • Upcoming Training
    • Mental Health Links
    • Physical Health Links
  • Contact
    • Florence Location
    • Mauldin Location
    • Lake City Location
  • Blog
  • Appointment Check In
1-888-255-9365

info@palmettofamilyworks.com

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Client Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.

  • Consent Signature Page
  • Consent Disclosure (keep for your records)
  • Parent Agreement (for minors only)
  • HIPAA notice. (keep for your records)
  • Developmental History (for minors only)

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Release of Information Form

Physicians & Agencies:

may click here for a Referral Form that can be faxed to

(843) 661-6030 for Florence/ Lake City

(864) 538-6906 for Mauldin

or emailed to referrals@palmettofamilyworks.com

Financial Forms:

  • Sliding Fee Scale

Note: To download Adobe Acrobat Reader for free, click here.

Contact Today

1-888-255-9365
info@palmettofamilyworks.com

Schedule An Appointment

About Us

My practice specializes in treating individuals, couples and families, and through years of experience, I’m confident that no problem is too great to overcome.

Office Hours

Office Hours are Available by Request

1-888-255-9365
info@palmettofamilyworks.com

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Location Information

2135-B Hoffmeyer Rd
Florence, SC 29501-4015

102 Renaissance Cir
Mauldin, SC 29662

121-A S Acline St
Lake City, SC 29560

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