Online Forms and Email/Internet Privacy Notice:

While unlikely, I accept that a breach of my privacy could occur when sending this information over the internet and/or when communicating by email and I am willing to accept that risk. I also understand that I have the option of printing this form and faxing it in or calling the office. For information on how we protect your privacy, please click here to view our privacy policy.
Alternatively, you may print individual or all intake form PDF’s and fax to 913-440-4745.

All of our on-line forms are created and kept secure via G-Suite, with whom we have signed a HIPAA Business Associate Agreement.  If you would like to read more about how G-Suite keeps your information private and secure, please refer to this page.

Take me to HIPAA Forms

Click here to download and print the form:
Beyond Function LLC, HIPAA

Complete and submit the form online here:

Take me to Consent & Financial Forms

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Beyond Function LLC -Consent & Financial Forms

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Take me to Release of Information Forms

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Beyond Function, LLC – Release of Information Form

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Take Me to Intake Forms

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Beyond Function, LLC – Intake Form

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