New Student Intake Form
Thank you for your interest in music lessons! This form will ensure that I have all the information I need to get you started. I teach voice, piano, and guitar lessons (ukulele for younger students) from beginning to advanced levels, all ages above 10 (6 for piano and ukulele), both virtual and in-person at my Ann Arbor Studio or at your home in the Ann Arbor area (no more than 20 mins away).

I welcome every musician, regardless of gender, color, orientation, religion, or perceived musical ability, to my studio. We focus on self-discovery, confidence, and joy through singing and music, and I strive to create a space where musicians feel safe to explore, try new things, and find their unique sound!

All of your answers to these questions are confidential between teacher and student (or teacher and parent). Please only answer what you feel comfortable answering!
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Student Name (as you would like me to address you): *
Parent Name (if filling out for your child):
Student Age: *
Student Gender Identity and Pronouns:
What instrument are you/the student interested in studying? *
For children younger than 10: please describe your child's reading ability.
Please describe your/the student's musical experience. Have you ever had lessons before, sung in choir, performed in a musical, taken dance classes, played in a band, sung karaoke, etc? *
Why did you/the student decide to take lessons? What are your musical goals that I should keep in mind? *
What kind of music do you/the student like to listen to/perform? Who are some of your favorite artists? *
What days would you prefer lessons? If you would like to specify a time, please type it in "Other;" most lessons are in the afternoons/evenings. *
Required
Please provide your contact info: email and/or cell phone number are preferred. *
For singers: are you a touring musician, teacher, coach, or other occupation required to speak or sing loudly for most of the day?
For singers: have you ever had issues with your voice like chronic hoarseness, sore throat after singing or talking, long periods of laryngitis, vocal hemorrhages, vocal nodules, vocal cysts, vocal polyps, or other voice conditions?
For singers: are you currently on hormone therapy treatment? Please only share if you feel comfortable--hormones can affect the voice, and I want to know how I can best help you explore, improve, and love your voice!
For singers: do you smoke, cigarettes or otherwise? How often?
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