Bethany Yates & Associates Personal Counseling and Consulting

Personal Counseling & Consulting

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Patient Forms

Select the appropriate form packet or individual form below, download and fill out prior to your visit:

Full Packets

Adult Intake Packet

Adolescent Intake Packet

Children’s Intake Packet

Individual Forms

Adolescent Facesheet

Adult Checklist

Adult Facesheet

Adult Information Form

Child / Adolescent Information Form

Consent to Release Form

Hippa

Important Information Form

Insurance

Minor Consent for Treatment

Teen Confidential Client History

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"After a few sessions with one of the therapists at Bethany, Yates & Associates, I was able to navigate and free myself from a traumatic event that had been coloring every aspect of my life.

There are no words to express my gratitude for my therapist, who literally guided me back to my own power. Allowing me to shape my future–under my terms."

P. VanHorn

Location | Phone

803 Stadium Drive
Suite 101
Arlington Texas 76011
817-459-2003

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