Client Forms
1) Required forms Informed Consent & Financial Agreement must be initialed, signed and emailed to your therapist prior to your first meeting.
2) Additionally, please complete one of the following, depending upon your interest in therapy:
3) In order for your therapist to interact with another therapist, a dietitian, doctor or family member, complete:
If you are a Health Coach client, please sign this, not the above therapy informed consent.
Please note that you will be asked to pay for sessions you do not attend, even in the event of an emergency, if less than 24-hours notice is given.
Due to the inevitability of un-expected schedule changes happening from time to time, each client will have one late cancellation waived within the course of his or her treatment. After that, any scheduled session, if not re-scheduled within the same week, will need to be paid.
Therefore, when possible, please reschedule within the same week, if you are unable to give more than a 24-hour cancellation notice.
For complaints against
Kathryn Gates, LMFT-Supervisor License no: 201522
this form can be submitted to:
Texas Behavioral Health Executive Council
Attn: Enforcement Division
333 Guadalupe St., Ste. 3-900 Austin, Texas 78701
Enforcement@bhec.texas.gov