Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.

Location

Address

715 North Washington Blvd,
Suite E,
Sarasota, FL 34237

Phone

941-343-7244

Appointment Request

Contact Us

Are you interested in learning about virtual Telehealth appointments? *

If Dr. Benson is not available *

Services *

Please do not submit any Protected Health Information (PHI).