Music Therapy Onboarding

Participant Name *

First Name

Last Name

Does the participant attend other therapies? *

Occupational Therapy

Speech Therapy

Physical Therapy

Art Therapy

Psychologist

Equine Therapy

Other (please provide details in 'Other Information' at end of form

None

Does the participant have a particular interest in certain instruments?

Guitar

Drums

Piano

Percussion

Singing

Dancing

Other

Service Agreement *

Music Therapy Service Agreement Term This Agreement shall commence at the date of completing this form, and shall continue until terminated by either party in accordance with the terms herein. Sessions are scheduled with school term dates unless otherwise arranged. Fees: Fees are aligned to NIDIS Pricing Guidelines available here: https://www.ndis.gov.au/providers/pricing-arrangements Session fees are: $193/60min session Or $96/30min session Cancellation Policy: The participant agrees to provide at least 24 hours' notice for any rescheduling of sessions. Failure to provide sufficient notice or no show may result in the participant being charged for the session. Confidentiality: Both parties agree to maintain the confidentiality of all information shared during the course of therapy sessions, except as required by law or with the written consent of the Client. Termination: Either party may terminate this Agreement at any time with written notice to the other party. Upon termination, the Client shall be responsible for any outstanding fees for services rendered.

I agree to these terms