Client Form 

Please fill out this form in its entirety to get started. We will reach out once we have received the form.

We accept a variety of insurance plans, including Cigna, Anthem, Blue Shield of California, Tricare, and United Healthcare, as well as services through the Frank D. Lanterman and Westside Regional Center and out-of-pocket payments.

We can also provide a monthly superbill if you’d like to submit for reimbursement through your out-of-network insurance.

Before submitting the form, please read our FAQ’s for answers to frequently asked questions and to view our current rates if you choose to pay privately.

We currently travel to your home, daycare, or child’s school in Koreatown, Echo Park, Beverly Hills, and Downtown Los Angeles. We also offer virtual speech therapy throughout California.

Conscious Speech Therapy Los Angeles

📧 lesly@consciousspeechtherapyla.com

📞 (213) 335-8051