Contactinquiry@venturatherapycollective.com5550 Telegraph Rd. Suite C3 Ventura CA 93003 Name * First Name Last Name Phone (###) ### #### Email * Insurance Provider Which insurance provider do you have? Anthem Blue Cross Optum/United/UMR Cigna / Evernorth Aetna None/Cash Pay Availability? * In Person Telehealth Mornings Afternoon/Evenings Monday Tuesday Wednesday Thursday Friday Saturday Who would you like to work with? Sarah Madason, ACSW Jennifer Stehle, AMFT Susanna Martinez, AMFT Ana Jaimes, AMFT Jessica Boghosian, ACSW Julia Youn, AMFT Amanda Cianci, ACSW Cheryl Peel, AMFT Briana Boskovich, AMFT Brionna Louis, AMFT Rachel Chavez, AMFT Darren Santos, APCC Alyssa Revelez, AMFT Sara Faulstitch, AMFT Maria-Blessilda Cabanban, AMFT Johanna Spokny, ACSW Where did you hear about us? * Anything else you would like us to know? Terms of Use * Please note that by using this web portal to submit the form, you understand and accept the potential risks associated with transmitting your health information through unencrypted email and electronic messaging. Despite these risks, you choose to proceed with submitting the form. By clicking "Yes, I want to submit this form," you agree to release Ventura Family Therapy Collective and all of it's associates", from any liability arising from unauthorized use, disclosure, or access to your protected health information sent through this electronic medium. Yes, I want to submit this form Thank you! We will reach out to you shortly!
