Referral Form

DV Therapy provides speech, OT, behavioral health, and mental health services in and around the areas of Antelope Valley, Bakersfield, Los Angeles and San Gabriel Valley.

If you are seeking an evaluation and/or services with DV Therapy Inc., please fill out the attached form.



    *ANY CHANGES TO THE ABOVE INFORMATION NEEDS TO BE COMMUNICATED TO OUR BILLING DEPARTMENT. FAILURE TO DO SO MAY RESULT IN A GAP IN SERVICE. THE FAMILY IS FINANCIALLY RESPONSIBLE FOR ALL SERVICES NOT COVERED BY INSURANCE*


    DV Therapy provides speech, OT, behavioral health, and mental health services in and around the areas of Antelope Valley, Bakersfield, Los Angeles and San Gabriel Valley.

    If you are seeking an evaluation and/or services with DV Therapy Inc., please fill out the attached form.

    • MM slash DD slash YYYY
    • *ANY CHANGES TO THE ABOVE INFORMATION NEEDS TO BE COMMUNICATED TO OUR BILLING DEPARTMENT. FAILURE TO DO SO MAY RESULT IN A GAP IN SERVICE. THE FAMILY IS FINANCIALLY RESPONSIBLE FOR ALL SERVICES NOT COVERED BY INSURANCE*

    • Max. file size: 100 MB.

    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.
    8 months 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.
    1 year 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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