Authorization for Credit Cards

In order to help us provide the best possible services to you and your child, please complete the following information.

    I authorize DV Therapy Inc to charge the amount listed above to the credit card provided herein. I agree to pay for this purchase in accordance with the issuing bank cardholder

    Cardholder – Please Sign and Date

    Check out our Reviews!

    5 star ratingOmmmg. We have been using DV therapy for about a month and love it here. Vedali is super patient and... read more

    Christine C. Avatar
    Christine C.
    2 years ago

    5 star ratingDV West Covina Office! What more can I say! Staff is excellent with all clients even our little... read more

    Marc J. Avatar
    Marc J.
    1 year ago

    5 star ratingWe have been going to DV for over a year and love it. They are so good with our son,... read more

    Kate P. Avatar
    Kate P.
    1 year ago