Metro Music Therapy & Studio PTC - TeleServices
Thank for your interest in virtual offerings for temporary maintenance of music therapy sessions or music lessons during this unprecedented national and global health crisis. Access to technology from your home setting will be required in order for virtual appointments to occur. These questions will help our staff to best prepare for appointments with your family or facility.
Any questions? Email:
or Call our office: 404-510-3799 with questions.
Client/Student Full Name
Who is your Therapist/Instructor?
Laura Lenz, LPMT, MT-BC
Maria Nichta, LPMT, MT-BC
Kevin Middlebrooks, LPMT, MT-BC
Bailey Hunt, LPMT, MT-BC
Hayley Oliver, LPMT, MT-BC
Haley Smith, LPMT, MT-BC
Do you have the equipment available to participate in online services (broadband internet access and a laptop/smartphone/tablet)?
What instruments, if any, do you have available at home?
Who will be available at during the tele-appointment to provide physical support if needed?
Sibling (18 years or older)
I will prepare a space for virtual appointments that has minimal distractions (not near open windows or entry ways), has writing utensils available, clean of snacks/food, etc.
No able to
I give consent for my therapist/instructor to send me an invitation to a Doxy.me account and to implement therapy/lessons through this account. I understand that Doxy.me is a HIPAA compliant online platform for telehealth services and that there is no additional cost to me or my family for using this online platform. I also agree to move all sessions/lessons to this online platform until MMT & Studio PTC can resume normal, in-person, day-to-day operations.
Send me a copy of my responses.
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This form was created inside of Metro Music Therapy, LLC.