Grace Note Singers Bedside Singing Request
Please call us at 401-400-0359 with your request or fill out this online form as completely as you are able. The purpose of this form is to guide us in providing you with a bedside singing experience that meets your needs.  We look forward to being in touch with you and sharing our voices with you and your loved one.

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Primary Care Giver Information
(Main Contact for Bedside Sing)
Full Name *
Relationship to Patient *
Best Phone Number *
Second Phone Number
Patient Information
Full Name *
Age *
Current Address (Street, City, State Zip) *
Any spiritual beliefs or practices of which we should be aware? *
What can you share with us about the person we'll be singing for (joys, work, family, mood) to help us in choosing songs to share. *
Physical Space
Description of physical space *
Who else might be present? *
Request Information
How many singers would you like? *
We usually come in groups of 4-6, but will do our best to adjust to your wishes
Preferred date of sing?
Preferred time for sing? (morning, afternoon, evening)
Duration of sing? (10-20 minutes is typical)
Are there any cats or dogs that might be present? *
If so, please list how many.
Additional comments or concerns
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