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Thank you for choosing to join Gaylesta, The LGBTQ Psychotherapy Association. The process takes three easy steps.

Step1: First you must register on our site using this form.

Step2: Once the registration has been processed, you must use the link sent to you in an email to activate the account.

Step3: Once the account is active, you must purchase a membership by going to our Membership Options Page

In using the forms below to register, please create a Username in the format lastnamefirstname (no spaces, no capitalization). Then use the same value in the 'Name' column on the right. If you have any questions about this process you can contact us by clicking here. Welcome!

Profile Details

Name (required)

First Name (required)

Your first name as you would like for it to appear on internal and public web pages.

Middle Name

Your middle name or initial, if you would like for it to appear on internal and public web pages.

Last Name (required)

Your last name as you would like for it to appear on internal and public web pages.

Category (required)

Indicate whether this membership is for an individual, clinic, or agency.

Mailing Address (required)

Enter your mailing address. This address will not be made public.

Mailing City (required)

Enter your mailing city. This information will not be made public.

Mailing State (required)

Enter your mailing state. This information will not be made public.

Mailing Zip Code (required)

Enter your zip code. This information will not be made public.

Work Phone (required)

Enter your work phone. This information will not be made public.

I agree to the terms of contract (required)

By indicating 'Yes', you agree to the full terms of the Contract with Gaylesta (for full terms, see here)

Account Details

Username (will autofill when you fill out your first and last name) Email Address (required) Choose a Password (required) Confirm Password (required)

Yes, I want to receive updates via email.

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Profile Details

Account Details

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