Returning Patient/rockSTAR Sign-Up Form (Salesforce)

Returning Patient/rockSTAR Sign-Up
Wherever you are, in-hospital or at-home, we are here to support you. Sign up today to receive a VIP ALL-ACCESS PASS to be a part of as many programs as you want or need. From 1:1 Music Therapy Sessions, Weekly Group Music & Art Therapy Sessions, rockSTAR Song Requests, and Livestream Performances with special shoutouts from stage, we are here to provide ongoing support and cheer for you! Open to all-ages, whole-family care & free for all patients and families.
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Livestream Performance Sign-Up

Already signed up as a rockSTAR? Enter your name and email address below to receive details about an upcoming show.
Is there a specific show you want to sign-up for?*
Send us a photo of yourself to share with our bands/artists!

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Anything else you'd like us to know? Comments/Questions?

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If Yes, what is your social handle(s) so we can tag you?

Group Music + Art Therapy Session Sign-Up

If you would like to join one or more of our weekly Group Music + Art Therapy Sessions, sign up below! We can't wait to connect with you!
Livestream Performance1:1 Music Therapy SessionrockSTAR Song Request

1:1 Music Therapy Session Sign-Up

If you would like to schedule a private 1:1 Music Therapy Session, sign up below! We can't wait to connect with you!
(Optional) Is there anything you would like to focus on during this session (i.e. goals, activities, etc.)?
1:1 Music Therapy
Livestream PerformanceGroup Music + Art Therapy SessionrockSTAR Song Request

rockSTAR Song Request

If you would like another rockSTAR Song Request, sign up below!
(Optional) Is there a specific song or artist you would like? Not sure? We have tons of great songs in mind for you!
Livestream PerformanceGroup Music + Art Therapy Session1:1 Music Therapy Session
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Returning Patient/rockSTAR Sign-Up