Parents & Caregivers

Have any questions or need help?
Call us at (713)510-5699 or email us at
You may also fill out the referral form below, and we will contact you as soon as possible!

Making a referral for your child is easy!

Does your child need speech, occupational or physical therapy? It only takes a call to (713)510-5699 to start the process.

  • Please have your child's insurance and physician information available.
  • Call us at (713)510-5699. We will gather all the insurance and physician information we need from you to request a doctor's order.
  • We will contact your child's doctor and insurance company to request authorization to evaluate your child.
  • After the signed orders are received by our administrative team we will contact you to schedule an evaluation.

Physicians & Referral Coordinators

You may submit a referral on our easy to use online referral form below or:

  • Fax the referral to (832)932-1629
  • Email the referral to
  • After you submit the referral form below we will contact you to confirm if the referral can or cannot be staffed within 48 hours. It's that simple!
  • Call us at (713)510-5699 or email us at


We accept traditional Medicaid, CHIP, and most Managed Care Insurances. A current list of insurance plans is listed below. If you have a specific question regarding insurance accepted at Personal Touch Therapy, please contact us at (713)510-5699. Please check back often as new insurance companies are added regularly.

For information on Texas Medicaid, including eligibility, enrollment, and coverage please visit the HHSC Texas Medicaid Program website. You may also call the toll free Medicaid Client hotline: (800)252-8263.

Our services are currently supported by the following insurance plans

Medicaid Health Plans
  • Traditional Medicaid
  • TX Children's Health Plan
  • Community Health Choice
  • Superior Health Plan
  • Amerigroup of Texas
  • Molina Healthcare
CHIP Health Plans
  • TX Children's Health Plan
  • Community Health Choice
  • Superior Health Plan
  • Amerigroup of Texas
  • Molina Healthcare

Referral Form

Patient Information

Yes No

Yes No

Parent/Guardian Information

Physician Information

Primary Areas of Concern
Language Comprehension
Verbal Expression
Voice Problems
Difficulty Swallowing/Feeding
Reading or Writing Difficulties
Oral Motor Difficulties
Fine Motor Delays
Gross Motor Delays
Walking Difficulties

In an effort to eliminate spam, we have added a captcha verification box below. Simply type the verification words you see in the box to submit the form. If you cannot read the words, click the refresh button within the captcha box to see new words.