(585)377-1000

SCHOOL-BASED SERVICES FOR CHILDREN

Click on the following links to download frequently requested forms.

(Completed forms can be mailed to the agency mailing address, or scanned and emailed to the agency email address)

For teachers, other professionals, or a parent referring a child in the school setting: Music Therapy Referral Checklist & Form

 

To complete for all referrals: Photo Video Release

 

More About the Process

Steps to obtaining services for someone you know:

Step 1 – Make A Referral

  • Parents: Click here to view and print the Music Therapy Referral Checklist Form. Complete the form and fax/mail it to our agency.
  • Teachers/Therapists:  Click here to view and print the Music Therapy Referral Checklist Form. Complete and submit one copy of each to the school district and one to our agency.
  • We will schedule a music therapy assessment upon receiving the pertinent paperwork from the parent and Committee on Special Education for children 3 years old or older.

Step 2 – Music Therapy Assessment

  • Our qualified therapists schedule and conduct music therapy assessments upon receiving a referral and appropriate paperwork from a parent, teacher, therapist, the Committee on Preschool Special Education, or the Committee on Special Education.
  • The assessment includes a review of current service reports, parent/teacher/therapist interviews, observations in a non-music setting, and implementation of music in a similar setting.
  • The data collected is compiled and presented in a Music Therapy Assessment Report.
  • Recommendations/Goals/Objectives are provided when there is proof of eligibility.

Step 3 – Determining Appropriate Setting for Services

  • A child under the age of 3 years old can receive services in the home, daycare, or at our center.
  • A child who is 3 – 5 years old can receive services in the home, daycare, in a pre-school setting, or at our center.
    • The Committee on Preschool Special Education determines the most appropriate setting for services when included on the IEP.
    • Parents choose their preferred setting when paying privately for services.
  • A child who is 5 – 21 years old can receive services in the home, daycare, in school, or at our center.
    • The Committee on Special Education requires services to be provided within the school setting.
    • Parents choose their preferred setting when paying privately for services.
  • An individual who is 21 year or older can attend a class or a lesson in the community, the home or at our center.

Step 4 – Scheduling and Beginning Therapy

  • After receiving approval to begin services the assigned therapist will contact the teacher, therapist and/or parent to schedule the approved frequency of sessions.
  • Once our agency receives the IEP documenting music therapy and a start date, or a private contract from the parent, services will begin.

Step 5 – Monitoring Progress

  • Our therapists will complete and provide quarterly and annual reports to document progress, strengths and needs.
  • Our therapists are always open to receiving contacts from parents, teachers and service providers.
  • Our therapists will attend annual meetings to share pertinent information and provide future recommendations.