Forms
All forms are available through our client portal; paper copies can be provided upon request. All forms marked with * are required in order for services to begin. Forms may be submitted via hard copy, client portal, or email IF consent to send/receive PHI over email has been signed.
1
Our policies and procedures explains our services and the requirements & processes involved with each service.
2
Acknowledgment form confirms that you have read and agree to policies and procedures packet.
3
Consent to communicate with specified third parties (Primary Care Providers, Family Empowerment Scholarship for Students with Unique Abilities, Sunshine Health Insurance/Medical Transportation Management)
5
In order to receive services through CMS Sunshine, the form must be completed in its entirety by client's primary care provider. Once completed, provider must fax form WITH client's most recent clinical info (such as an after visit summary) AND prescription for music therapy services.
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Please note that even if you or your PCP's office receive confirmation of approval, we are unable to begin services until we also have the authorization loaded into our portal. This may take a few additional business days after you receive approval.
6
For existing clients: Please sign and complete this notice acknowledging your understanding of our pricing increase for scholarship services in 2025.
7
For existing clients: Please sign and complete this notice acknowledging your understanding of our pricing increase for private pay services in 2025.
Service Radius
Currently, we are accepting waitlist clients within a 15 mile radius of the 33803 zip code. While therapist availability for sessions varies day to day depending on your assigned therapist, our official business hours are as follows:
Opening Hours
Mon - Fri
9:00 am – 5:00 pm
Saturday
Closed
​Sunday
Closed