Intake Form - ADULT

Thank you for your interest in THE PALMETTO PARTNERSHIP.
Your input helps us locate services and support in our area that you are seeking.
Please provide as much information and detail as possible, so that we will have the background we need to find appropriate resources. The more information we have, the more help we can provide.

Contact Information:

Background/Medical Information:

Thank you for taking the time to complete the intake form. We are so glad you reached out to us, and hope to provide you with the support and resources that you need.

For information on various agencies and organizations that provide disability services and resources, please go to the RESOURCE LINKS TAB on our website:

The mission of THE PALMETTO PARTNERSHIP of All 4 Autism is to increase the quality of life of those with disabilities, and their families, by providing free resources, support and advocacy services, while actively seeking opportunities to partner with others and serve as ambassadors of goodwill in our community. We are a grassroots organization, and all of our services are free and open to the public.


WANT TO HELP SUPPORT OUR EFFORTS? Please consider becoming a PALMETTO PARTNER through our recurring giving program. For more information: