Thanks for reaching out.

1

If you have any questions, feel free to contact us.

Email: counseling@seacoast.org

Call or text: 843-901-4459

2

Rates for The Counseling Center at Seacoast.

Individual Session: $110

Marriage or Family Session: $135

90-minute Intake Session: $175

You may request a scholarship to reduce these rates by $50/session if approved.

3

Type of Counseling* This field is required.

Individual

Marriage

Couple

Family

4

Name* This field is required.We cannot use or share your personal information for any purpose other than registration.

First Name

Last Name

5

Gender* This field is required.

Male

Female

Prefer not to say

6

Date of Birth* This field is required.

Date

7

Phone Number* This field is required.

Please enter a valid phone number.

8

Email* This field is required.

example@example.com

9

State of Residence

10

Additional name (required for marriage, couple, or family counseling)

First Name

Last Name

11

Gender

Male

Female

Prefer not to say

12

Date of Birth

Date

13

Phone Number (must be a different phone number)

Please enter a valid phone number.

14

Email (must be a different email)

example@example.com

15

Reason for requesting counseling. * This field is required.

16

Please share anything else you would like us to know. * This field is required.