Engage Counseling & Wellness is committed to protecting your privacy and the confidentiality of your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and South Carolina state law.

Please note that this form is intended for general inquiries and appointment requests only. While the information you submit will be transmitted securely and treated as confidential, it should not be used to share sensitive or emergency information. Submitting this form does not create a therapist–client relationship.

If you are experiencing a mental health emergency, please call 911, go to your nearest emergency department, or contact the 988 Suicide and Crisis Lifeline.

By submitting this form, you acknowledge and consent to Engage Counseling & Wellness using the information provided to contact you for scheduling or consultation purposes.