Music Therapy Intake Form - Victoria Conservatory of Music
Centre for Music Therapy About Music Therapy Music Therapy Intake Form

Music Therapy Intake Form

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

Please fill out and submit the following information and the Head of the Centre for Music Therapy and Wellness will contact you to discuss who might be the best music therapist(s) for this participant.

  • Contact Information

  • MM slash DD slash YYYY

  • Availability

  • * For school age children and youth, do you know that many of our participants attend with their EA from schools or BI? Please chat with the school if this something that could work best for you.

  • Please tell us more about the participant who would be attending Music Therapy Sessions

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