Polarity Therapy Intake
Intake & Informed Consent Form
For Polarity Therapy Session Work with Kate Randall
Welcome
Thank you for choosing to work together. Before beginning, please read the Informed Consent section below. It outlines the nature of this work, scope of services, and session policies.
By submitting this form, you acknowledge that you have read and agreed to the informed consent and terms provided. If you have questions, I’m happy to discuss them with you during our first session.
This form serves as a mutual agreement between us and the foundation for our work together.
Session Logistics
Online Sessions
Held via Zoom. A link will be provided before our session. Please ensure you’re in a quiet space with a stable internet connection and a device with a camera and microphone.
In-Person Sessions
Location:
Dogpatch Collective
1661 Tennessee Street #3D Studio 4
San Francisco, CA 94107
Entry Instructions:
Please locate Dogpatch Collective on the Intercom and call. I will let you in remotely
For assistance, call/text: (415) 255-5762
Payment & Cancellation Policies
Session Fee: $200
Payment is due prior to or at the start of each session.
Accepted Payment Methods: Venmo, Zelle, Credit Card, Cash, or Check
Cancellations:
You may cancel or reschedule with at least 48 hours’ notice with no fee.
Sessions canceled with less than 48 hours’ notice or no-shows will be charged the full session fee.