Patricia Grullon, LMFT - ZendaTherapy, LLC

Patricia Grullon, LMFT - ZendaTherapy, LLC Send Message

Who would be receiving care?

Me

My partner and me

Someone else

Your info

First name

Last name

Email

Phone

Name you go by

Date of birth

State

Select the state you live in

Reason for care

What is the reason for seeking care?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Other

Client Preferences

Preferred appointment times

Please give preferred days for your appointments.

Morning Afternoon Evening Weekend

Is there anything that the practitioner needs to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

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Preferred Day of the week

Please select the day of the week that works best for an appointment

Monday Tuesday Wednesday Thursday Friday Saturday

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.