Sign up to The Rhythmic Breath - Maldon
Come along to this FREE music therapy group where we will support you through music. For anyone struggling with chronic health, long Covid, mental health or general stress and worry.

Here you are safe to share, explore your feelings, relax and express yourself through listening to and playing music.

Date: Every Monday from the 6th of June 2022 for 8 weeks
Time: 10:45am - 11:45am
Place: West Maldon Community Centre, CM9 6YH

Sign in to Google to save your progress. Learn more
Email *
Name *
Contact Number *
Next of Kin's Name *
Next of Kin's Contact Number *
Do you have a diagnosis? If yes please state *
Is there any medical information we should be aware of? *
Is there any other additional information you'd like us to know before you attend? *
Which sessions do you plan to come to? *
Required
Please can you let us know if you ever can't attend a session via email (saskia@acemusictherapy.co.uk) *
Do you consent to pictures and videos for us to use on Ace Music Therapy's social media? *
Would you like to sign up to our Newsletter to recieve updates about music groups in the future? *
Please copy and paste this link (https://forms.gle/pLe2Mf7TgKrBQbR8A) to complete our referral form before attending, if you haven't already
Thank you for signing up to The Rhythmic Breath - Maldon, we look forward to making music with you!
Becky and Katie improvising for The Rhythmic Breath
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Ace Music Therapy. Report Abuse