
Kinsey Keller, MA, LPC, LMHP
308-765-8027
10 Pinckney Colony Road,
Building 300, Suite 301,
Bluffton, SC 29909
Kinsey Keller, MA, LPC, LMHP
308-765-8027
10 Pinckney Colony Road,
Building 300, Suite 301,
Bluffton, SC 29909

INITIAL FORMS
INITIAL FORMS
PLEASE READ BELOW!
Let's save time before your first session! For current safety reasons there is no option to complete these forms in our office and they must be completed before your first session. If you are completing them from your phone you do not need to download the app click "Sign With Mobile Browser".
Know that if you are coming for marriage/couples/family counseling you each will need to complete your own "New Patient: form. If you are under the age of 19 your parent will need to sign with your forms with you. Follow the tabs some are required and some are optional. At the end you will get a confirmation that your document has been sent and your welcome to download and save a copy for yourself.
If you are coming for marriage/family/couples counseling only one person will need to complete the "payment form" link for the family. Even if you are paying with our cash discount the form will still be required to be completed.
Click below to begin filling out the New Patient Form and Payment Information.
REQUIRED
Payment and New Patient Form
Click Below!
https://signnow.com/s/VTJuuWhO
https://signnow.com/s/OK7VS81o
If your wanting to have anyone included in your treatment such as your primary care physician, lawyer, or family please fill out the document below.
(Not Required)
https://signnow.com/s/mPdCk1Rh