Client Forms

*Required forms Informed Consent & Financial Agreement must be initialed, signed and emailed to your therapist prior to your first meeting.

Psychotherapy Intake Form  Couples Intake  Release of Information

Coaching Informed Consent  Group Financial Agreement

 

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.

Contact Gates Therapy here.

 

 

 

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