New Patient Assessment Form

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Music Therapy has impacted the health of millions worldwide in a clinical proved, non-invasive and natural way. Fill out the form to request a 15 minute free consultation from one of our certified professors. Generally, after the consultation we will customize a treatment package for you. The model will be either: 1-on-1, 1-on-1 with patients/ siblings, 1-on-group.
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- Please Select One
- Child
- Adult
- Senior
What best describes patient
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This form is for first time 15 minute consultation only. After consultation we will set up a one hour assessment. If you are a current patient and would like to make appointment, please go to the appointment form.