Powdersville
103 CLAIR DRIVE SUITE C, PIEDMONT, SC 29673
PHONE: (864) 509-1337 SECURE FAX: (864) 416-4799
Greer
52 PARKWAY COMMONS WAY, GREER, SC 29650
PHONE: (864) 655-4350 SECURE FAX: (864) 416-4799
I UNDERSTAND THAT MY RECORDS ARE PROTECTED UNDER THE FEDERAL REGULATIONS AND CANNOT BE DISCLOSED WITHOUT MY WRITTEN CONSENT UNLESS OTHERWISE PROVIDED FOR IN THE REGULATIONS. I ALSO UNDERSTAND THAT I MAY REVOKE THIS CONSENT AT ANY TIME EXCEPT TO THE EXTENT THAT ACTION HAS BEEN TAKEN IN RELIANCE ON IT.