Adult Discharge Plan

Patient's Name(Required)
MM slash DD slash YYYY
The clinician has summarized the reasons for treatment and the extent to which treatment goals were made

Please choose a reason for discharge:

Reached age-appropriate function
The clinician has shared specific follow up activities and tips I can implement after termination of services.
I am aware I can reach out DV Therapy for any comments, questions, or aftercare in regards to my child’s speech and language anytime
Signature: Type out name as your signature(Required)
MM slash DD slash YYYY

Thank you for selecting our clinic. We were so thrilled to work with you and your child. We wish you and your family success in all your future endeavors.

5 star ratingI love bringing my little one here. I've notice such a big difference in her speech. And Ms.Rachel is amazing... read more

Bianca C. Avatar
Bianca C.
1 month ago

My 2 year old son has been improving so much over the last few months & im very thankful for... read more

Stephanie De Cosse Avatar
Stephanie D.
7 months ago

Im beyond happy with the services my daughter is receiving. Her therapist Lupe has done an amazing job, from keeping... read more

Ness M Avatar
Ness M.
1 year ago
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