1-800-326-8621
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Parent Leadership Network
3601 Meeting Street Road
Suite H
North Charleston, South Carolina 29405
843-747-0480

Parents Anonymous® Referral Form

This form is for any parent or caregiver interested in attending a Parents Anonymous® Support Group. Parents and caregivers are able to self refer themselves to a support group by completing the form. If you are a state agency or community partner, you may complete the form on behalf of the parent or caregiver. Once the form has been submitted, a member of our staff will contact the parent and referral contact to confirm the support group time and location.

FamilyCorps can provide a report on a referred client only if a parent consent form download here is signed and faxed to the FamilyCorps office at 843-747-0890.



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