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MAPLE COUNSELING CENTER
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New Client Forms

For first appointment: New Client Intake Packet
​Please bring these completed forms with you to your appointment, or ask your provider to send intake forms with electronic signature to do online.

​​Additional Forms: These forms may be used when prompted by your therapist. 
Medical Information
Release of Information
Consent for Treatment​

For Providers Only

Provider Forms 
Provider Protocols and Videos
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© Maple Counseling Center
2021 Sperry Ave. Suite 41
Ventura, CA 93003
​(805) 669-8846 | Fax: (805) 272-9370
[email protected]
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