DBT Informed Music Therapy Program

Enrollment

Congratulations for enrolling your music therapist(s)

Step 1: Fill Out this Employer Enrollment Form
So we can match your payment with the correct participant and send a confirmation.
Step 2: Complete Payment (will appear once you submit this form)
Secure your therapist’s place in the program.
Spots are limited. Payment guarantees enrollment.

First Name of Music Therapist

Last Name of Music Therapist

Email of Music Therapist *

Phone Number of Music Therapist *

What benefits do you see for your music therapist being part of this program?

What is your workplace's interest in DBT?

I agree to terms & conditions provided by the company. By providing my therapists cell phone number, they agree to receive SMS notifications, reminders, alerts & occasional marketing communication from The Spiegel Academy. Message frequency varies. Message & data rates may apply. (You/they can opt-out by replying STOP at any time.)