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Hope & Harmony NJ

Music Therapy Services Contract

Child's Birthday
Month
Day
Year

Please indicate if a sibling will also be participating in therapy services and their current age

Location for Services, as discussed
Type of Session
1-on-1, 30-45 minutes ($80)
1-on-1, 60 minutes ($100) *can split between siblings
1-on-1 specialized, 45 minutes ($125) *psych or brain injury rehab
Other, as discussed

By signing this contract, I am agreeing that Hope & Harmony NJ will be conducting weekly (unless otherwise discussed) music therapy sessions at the location and length of time agreed upon by both parties.

I acknowledge the following:

-Sessions are currently fee for service and should be paid for in full by the start of each session. Monthly payment is accepted as well, if desired.

-Payment options: cash OR check payable to Hope & Harmony NJ OR Zelle to owner.hopeandharmonynj@gmail.com

-Credit Card payment is accepted for an additional 3% processing fee.

-Sessions are non-refundable but I am not locked into services for a specific amount of time. However, we do suggest a minimum of 4 weeks to assess services.

-At least 24hr Cancellation Notice is required unless there is a family/medical emergency or severe illness. If I fail to notify Hope & Harmony NJ of cancellation, this will be considered a "no show" and I will still owe payment for that session.

-Rescheduling and make-ups are available upon request by both parties.

-This is a very low risk service and I will not hold Hope & Harmony NJ liable for any injuries or damages (personal, property, or otherwise) that may occur.

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Hope & Harmony NJ, LLC

Colts Neck, NJ 07722

908-839-5145

info.hopeandharmonynj@gmail.com

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