Request for Mental Health Services
If you are interested in mental health counseling, please fill in the form below. We offer therapy sessions both virtually (through Zoom) and in-person. Please indicate your preference; if you are unsure, we recommend starting with a virtual session and you can always move to in-person later. After we receive your form, we will email you with the date and time of your first session. At this session we will discuss your needs, assess whether our services are the right fit for you, and make a plan for moving forward. 

Please be sure to include all your available weekdays/times (during business hours). Our hours are: Monday-Thursday: 9:00am – 5:00pm and Friday: 9:00am – 1:00pm. We also offer virtual evening hours on Tuesdays from 5:00pm -- 7:00pm. The more availability you include the sooner you will be scheduled. 

If this is a mental health emergency please call 888-724-7240 or 911, or text "COURAGE" to 741741

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Today's date *
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Email Address *
Phone Number *
First and Last Name (as shown on student ID) *
Student ID Number *
Date of birth *
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Are you currently living in California? *
Required
Are you currently taking classes this semester? *
Have you been seen for a mental health appointment at Grossmont College before? *
If yes, would you prefer to work with your previous therapist if possible?  *
I would prefer my appointments to be
Please check ALL windows of time during which you are currently available. Sessions are 45 minutes. We will assign your first session during one of the times that you indicate. *
Required
Please tell us why you are seeking therapy (ex. "to manage depression" or "relationship issues"). You can keep this very general and brief. 
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