Centre for Music Therapy About Music Therapy Music Therapy: Community Sites Intake Form

Music Therapy: Community Sites Intake Form

We are Canada's Leading Centre for Music Therapy and Wellness

General Information
$67.00/hour (or $33.50/30 minutes or $50.25/45 minutes) plus a mileage fee per visit ($6.50 or $9.50 depending on distance from the VCM). Music Therapists visit your site with a variety of instruments. Hand bell choir available.
Contact name*
First Last
Name of Community site*
Contact phone*
Contact email
City and Municipality of site*
Brief summary of participants' diagnosis, ages, strengths, and challenges
Preferred day(s) of the week for sessions*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
Preferred time(s) (specific times or time range)*
Length of time (30 minutes, 60 minutes, etc.)*
Format of sessions: (Options include one weekly session, or a weekly block of time divided between a few participants.)*

General Information