7111 West 151st Street, Suite #286, Overland Park, KS 66223

Intake Forms

Intake forms are required for all new patients.

To expedite the process on your first appointment, please download, print, and fill out the following forms to bring in to the office on the day of your first visit.

New Patient Form (for an Adult)

New Patient Form (for a Child)

HIPPA Information

Release of Information

Psychotherapist-Patient Agreement

Teletherapy Informed Consent

Learn more about Dr. Benson on psychologytoday.com
Learn More

© Copyright 2023 - All Rights Reserved.

faxenvelopephonemap-marker