Mental Health Services - Forms
Maryvale's Community-Based Services provides information and referrals for any family, individual or agency requesting Mental Health assistance outside our service area, linking them to resources and services to meet their Mental Health needs.
Click on links below to download PDF forms:
Publicly Funded Mental Health Services Provider Directory Guide (LA County 2023)
Click Here To Go To The Online Provider Directory
Publicly Funded Mental Health Services Provider Directory (LA County 2018) *All Service Areas
Publicly Funded Mental Health Services Provider Directory (LA County 2019) *Service Area 3 Only
County of Los Angeles - Mental Health Plan Beneficiary Handbook
Grievance and Appeal Authorization Procedure (English)
Grievance or Appeal and Authorization Form (English)
Grievance and Appeal Authorization Procedure (Spanish)
Grievance or Appeal and Authorization Form (Spanish)
Change of Provider Form (English)
Change of Provider Form (Spanish)