Interested in Adolescent Therapy (12-18)?Fill in the form on this page to get started, and we will get back to you asap.If you do not hear back from us within 5 business days, please check your junk/spam folder and/or reach out to us again at info@b2bpsychotherapy.com Meet our Adolescent Therapy team Dr. Erin Skiffer Dr. Stephanie Lopez Dr. Kaitlin Venema Dr. Erin Yip Dr. Rae Turner Dr. Nicolas Chu Dr. Alexis Petrakis Dr. Brandi Marcaletti Dr. Alissa Vannet Name of the person completing this form * First Name Last Name Email of the person completing this form * Phone number of the person completing this form * (###) ### #### Provider * If you are interested in working with a specific provider, indicate your preference below (you may choose more than one provider) Erin Skiffer, Psy.D. (San Francisco & Corte Madera) Nicolas Chu, Psy.D. (Corte Madera) Stephanie Lopez, Psy.D. (San Francisco & Corte Madera) Alexis Petrakis, Psy.D. (Petaluma & Corte Madera) Kaitlin Venema, Ph.D. (Petaluma & Corte Madera) Brandi Marcaletti, Ph.D. (Corte Madera) Erin Yip, Psy.D. (San Francisco & Corte Madera) Alissa Vannet, Psy.D. (Corte Madera & Oakland) Diana Le, Ph.D. (Virtual) No Preference Location * What is your preferred location? Corte Madera San Francisco Petaluma Oakland Virtual Only What is the name of the adolescent who is seeking therapy? Please enter the age of the adolescent seeking therapy? Please provide a brief description of your reasons for seeking therapy at this time * Has the adolescent been treated in any of the following settings (check all that apply)? * Medication management with a psychiatrist Previous psychotherapy Intensive Outpatient Programs (IOP) Partial Hospitalization Programs (PHP) Psychiatric hospitalization Residential Treatment None of the above Is the patient seeking treatment insured by Medicare? Yes No Availability * Below, please enter times during the week (Monday - Friday) when the adolescent who is seeking therapy could be available for a regular therapy appointment. This will help us find a therapist with suitable openings. Please note that our availability is limited, so we encourage you to include all possible appointment times. We will do our best to accommodate your preferred time. Thank you!
