Facility name Contact person Email address Population(s) serviced Immunizations required by employees and volunteers Identify the orientation and training program that is required for all employees and volunteers. Check all that apply. Beginning First Aid CPR Documentation Infection Control Orientation to Facility Orientation to Procedures Other Recipient Rights Protocol Please provide a brief description of each: CPR - None -One-time Seminar1 to 2 Hours2 to 4 Hours6 to 8 HoursTwo-day SeminarOther FIrst aid - None -One-time Seminar1 to 2 Hours2 to 4 Hours6 to 8 HoursTwo-day SeminarOther Infection control - None -One-time Seminar1 to 2 Hours2 to 4 Hours6 to 8 HoursTwo-day SeminarOther Orientation - None -One-time Seminar1 to 2 Hours2 to 4 Hours6 to 8 HoursTwo-day SeminarOther Are these training opportunities offered at the beginning of the semester so that our students may be included? - None -YesNo Would you be willing to provide an individualized orientation to the music therapy students to discuss facility protocol and other applicable issues? SelectYesNo Would these be complimentary or is there a fee attached? - None -No FeeFee Explain any additional services that are necessary for your facility. Will music therapy students be able to read patients' charts? SelectYesNo If you have a Recipient Rights Statement, will a copy be supplied to Western Michigan University's Music Therapy Clinic? SelectYesNo Will music therapy students have access to current diagnostic, medication and medical intervention information? SelectYesNo Will students be able to review I.E.P. information with parental consent? - None -YesNo Will students be able to attend an I.E.P./treatment team meeting for professional growth? SelectYesNo Additional comments Leave this field blank Submit
