{"id":598,"date":"2024-02-22T11:43:33","date_gmt":"2024-02-22T17:43:33","guid":{"rendered":"https:\/\/uabforms.hs.uab.edu\/blogs\/greyform\/?page_id=598"},"modified":"2024-02-22T11:43:33","modified_gmt":"2024-02-22T17:43:33","slug":"music-therapy-internship-program","status":"publish","type":"page","link":"https:\/\/uabforms.hs.uab.edu\/blogs\/greyform\/index.php\/music-therapy-internship-program\/","title":{"rendered":"Music Therapy Internship Program"},"content":{"rendered":"<script type=\"text\/javascript\">if(!gform){document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0});var gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),null==t&&(t=10),gform.hooks[o][n].push({tag:i,callable:r,priority:t})},doHook:function(o,n,r){if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[o][n]){var t,i=gform.hooks[o][n];i.sort(function(o,n){return o.priority-n.priority});for(var e=0;e<i.length;e++)\"function\"!=typeof(t=i[e].callable)&#038;&#038;(t=window[t]),\"action\"==o?t.apply(null,r):r[0]=t.apply(null,r)}if(\"filter\"==o)return r[0]},removeHook:function(o,n,r,t){if(null!=gform.hooks[o][n])for(var i=gform.hooks[o][n],e=i.length-1;0<=e;e--)null!=t&#038;&#038;t!=i[e].tag||null!=r&#038;&#038;r!=i[e].priority||i.splice(e,1)}}}<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_159' ><div id='gf_159' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_159' id='gform_159'  action='\/blogs\/greyform\/index.php\/wp-json\/wp\/v2\/pages\/598#gf_159' novalidate>\n                        <div class='gform_body gform-body'><div id='gform_fields_159' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_159_1\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" ><strong>Internship Program:<\/strong>\n<\/br>\n<\/br>\n<ul>\n<li>Comprehensive and intensive training under the supervision of several MT-BCs in every area of medical concentration, including general inpatient acute care, adult ICU, Bone and Marrow Transplantation & Cell Therapy Program, Heart\/Lung Transplant, Level I Trauma\/Burn Center, Palliative and Comfort Care Unit, Level IV Neonatal ICU (NICU), adolescent and adult psychiatry, geriatric psychiatry, and inpatient rehabilitation.<\/li>\n<li> Opportunities for co-treating with multiple disciplines, including Physical Therapy, Occupational Therapy, Speech Therapy, support coordinators, and chaplains<\/li> \n<li>Opportunities to participate in interdisciplinary treatment team meetings<\/li> \n<li>Opportunities to participate in educational services for medical staff<\/li>\n<\/ul>\n<\/br>\nIntership Entry-Level Requirement:\n<\/br>\n<\/br>\n<ul>\n<li>Applicants must be within six months of completing undergraduate or equivalency degree in music therapy from an accredited university.<\/li>\n<li>Proficient in guitar, voice, and piano.<\/li>\n<li>Functional and diverse musical skills, with repertoire that includes but is not limited to hymns\/gospel, country, rock, jazz, show tunes, R&B, and popular music.<\/li> \n<li>Ability to lead group sessions while singing and performing on guitar.<\/li> \n<li>Basic knowledge of medical diagnoses, music therapy techniques, and common medical music therapy goals.<\/li>\n<li>Professional interpersonal skills.<\/li>\n<\/ul>\n<\/br>\nWinter\/Spring Deadline: Submit application by May 31<\/br> \nSummer\/Fall Deadline: Submit application by December 31\n\n<\/div><fieldset id=\"field_159_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Applicant&#039;s full legal name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_159_2'>\n                            \n                            <span id='input_159_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_159_2_3' value='' aria-label='First name'   aria-required='true'     \/>\n                                                    <label for='input_159_2_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_159_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_159_2_6' value='' aria-label='Last name'   aria-required='true'     \/>\n                                                    <label for='input_159_2_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_159_3\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_3' >Phone number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_159_3' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_159_4\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_4' >Best time of day for contact:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_159_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_5\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_5' >Email address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_159_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_159_6\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Mailing address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_159_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_159_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_159_6_1' value=''    aria-required='true'    \/>\n                                        <label for='input_159_6_1' id='input_159_6_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_159_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_159_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_159_6_2' id='input_159_6_2_label' >Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_159_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_159_6_3' value=''    aria-required='true'    \/>\n                                    <label for='input_159_6_3' id='input_159_6_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_159_6_4_container' >\n                                        <select name='input_6.4' id='input_159_6_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_159_6_4' id='input_159_6_4_label' >State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_159_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_159_6_5' value=''    aria-required='true'    \/>\n                                    <label for='input_159_6_5' id='input_159_6_5_label' >ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_159_6_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_159_7\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_7' >Name of school:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_159_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_8\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_8' >Primary instrument:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_159_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_9\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_9' >Current overall GPA:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_159_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_10\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_10' >Hours of pre-internship experience (prior to start date):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_159_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_11\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_11' >List pre-clinical training sites and briefly describe goals worked on with each population:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_159_11' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_159_12\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_12' >Degree pursued (undergraduate, graduate, equivalency):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_159_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_14\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_14' >Requested internship start date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_14' id='input_159_14' type='text' value='' class='datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_159_14_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_159_14_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_159_14' class='gform_hidden' value='https:\/\/uabforms.hs.uab.edu\/blogs\/greyform\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_159_15\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Professor\/Academic Advisor Contact Information:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_159_15'>\n                            \n                            <span id='input_159_15_3_container' class='name_first' >\n                                                    <input type='text' name='input_15.3' id='input_159_15_3' value='' aria-label='First name'   aria-required='true'     \/>\n                                                    <label for='input_159_15_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_159_15_6_container' class='name_last' >\n                                                    <input type='text' name='input_15.6' id='input_159_15_6' value='' aria-label='Last name'   aria-required='true'     \/>\n                                                    <label for='input_159_15_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_159_16\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_16' >Phone number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_16' id='input_159_16' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_159_17\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Please select one:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_17'>\n\t\t\t<div class='gchoice gchoice_159_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Work'  id='choice_159_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_17_0' id='label_159_17_0'>Work<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Cell'  id='choice_159_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_17_1' id='label_159_17_1'>Cell<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Home'  id='choice_159_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_17_2' id='label_159_17_2'>Home<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_159_18\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_18' >Best time of day for contact:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_159_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_159_19\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_19' >Email:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_19' id='input_159_19' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_159_20\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Using the scale below, accurately rate your comfort level with the following skills and concepts:<\/h3><div class='gsection_description' id='gfield_description_159_20'>1 2 3 4 5 \nVery Low, Average, Very High<\/div><\/div><fieldset id=\"field_159_22\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Assessment for music therapy services:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_22'>\n\t\t\t<div class='gchoice gchoice_159_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='1'  id='choice_159_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_22_0' id='label_159_22_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='2'  id='choice_159_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_22_1' id='label_159_22_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='3'  id='choice_159_22_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_22_2' id='label_159_22_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_22_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='4'  id='choice_159_22_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_22_3' id='label_159_22_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_22_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='5'  id='choice_159_22_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_22_4' id='label_159_22_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_23\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Iso principle &amp; entrainment:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_23'>\n\t\t\t<div class='gchoice gchoice_159_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='1'  id='choice_159_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_23_0' id='label_159_23_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='2'  id='choice_159_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_23_1' id='label_159_23_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='3'  id='choice_159_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_23_2' id='label_159_23_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='4'  id='choice_159_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_23_3' id='label_159_23_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_23_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='5'  id='choice_159_23_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_23_4' id='label_159_23_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_24\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Lyric analysis:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_24'>\n\t\t\t<div class='gchoice gchoice_159_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='1'  id='choice_159_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_24_0' id='label_159_24_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='2'  id='choice_159_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_24_1' id='label_159_24_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='3'  id='choice_159_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_24_2' id='label_159_24_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='4'  id='choice_159_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_24_3' id='label_159_24_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='5'  id='choice_159_24_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_24_4' id='label_159_24_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_25\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Relaxation techniques:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_25'>\n\t\t\t<div class='gchoice gchoice_159_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='1'  id='choice_159_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_25_0' id='label_159_25_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='2'  id='choice_159_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_25_1' id='label_159_25_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='3'  id='choice_159_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_25_2' id='label_159_25_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='4'  id='choice_159_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_25_3' id='label_159_25_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='5'  id='choice_159_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_25_4' id='label_159_25_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_26\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Group management:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_26'>\n\t\t\t<div class='gchoice gchoice_159_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='1'  id='choice_159_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_26_0' id='label_159_26_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='2'  id='choice_159_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_26_1' id='label_159_26_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='3'  id='choice_159_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_26_2' id='label_159_26_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='4'  id='choice_159_26_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_26_3' id='label_159_26_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='5'  id='choice_159_26_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_26_4' id='label_159_26_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_28\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Interpreting medical equipment data (i.e. vital signs):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_28'>\n\t\t\t<div class='gchoice gchoice_159_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='1'  id='choice_159_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_28_0' id='label_159_28_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='2'  id='choice_159_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_28_1' id='label_159_28_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_28_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='3'  id='choice_159_28_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_28_2' id='label_159_28_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_28_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='4'  id='choice_159_28_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_28_3' id='label_159_28_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_28_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='5'  id='choice_159_28_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_28_4' id='label_159_28_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_27\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Session documentation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_27'>\n\t\t\t<div class='gchoice gchoice_159_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='1'  id='choice_159_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_27_0' id='label_159_27_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='2'  id='choice_159_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_27_1' id='label_159_27_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='3'  id='choice_159_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_27_2' id='label_159_27_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='4'  id='choice_159_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_27_3' id='label_159_27_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='5'  id='choice_159_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_27_4' id='label_159_27_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_159_29\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Rate your proficiency in the following areas:<\/h3><\/div><fieldset id=\"field_159_30\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Guitar:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_30'>\n\t\t\t<div class='gchoice gchoice_159_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='1'  id='choice_159_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_30_0' id='label_159_30_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='2'  id='choice_159_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_30_1' id='label_159_30_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='3'  id='choice_159_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_30_2' id='label_159_30_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_30_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='4'  id='choice_159_30_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_30_3' id='label_159_30_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_30_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='5'  id='choice_159_30_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_30_4' id='label_159_30_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_31\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Piano:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_31'>\n\t\t\t<div class='gchoice gchoice_159_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='1'  id='choice_159_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_31_0' id='label_159_31_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='2'  id='choice_159_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_31_1' id='label_159_31_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='3'  id='choice_159_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_31_2' id='label_159_31_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_31_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='4'  id='choice_159_31_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_31_3' id='label_159_31_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_31_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='5'  id='choice_159_31_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_31_4' id='label_159_31_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_32\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Other instruments (specify):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_32'>\n\t\t\t<div class='gchoice gchoice_159_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='1'  id='choice_159_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_32_0' id='label_159_32_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='2'  id='choice_159_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_32_1' id='label_159_32_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='3'  id='choice_159_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_32_2' id='label_159_32_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='4'  id='choice_159_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_32_3' id='label_159_32_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_32_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='5'  id='choice_159_32_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_32_4' id='label_159_32_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_33\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Voice:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_33'>\n\t\t\t<div class='gchoice gchoice_159_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='1'  id='choice_159_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_33_0' id='label_159_33_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='2'  id='choice_159_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_33_1' id='label_159_33_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_33_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='3'  id='choice_159_33_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_33_2' id='label_159_33_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_33_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='4'  id='choice_159_33_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_33_3' id='label_159_33_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_33_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='5'  id='choice_159_33_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_33_4' id='label_159_33_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_159_34\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Accurately rate your knowledge of music therapy with the following populations:<\/h3><\/div><fieldset id=\"field_159_35\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Neonatal:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_35'>\n\t\t\t<div class='gchoice gchoice_159_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='1'  id='choice_159_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_35_0' id='label_159_35_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='2'  id='choice_159_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_35_1' id='label_159_35_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='3'  id='choice_159_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_35_2' id='label_159_35_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='4'  id='choice_159_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_35_3' id='label_159_35_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='5'  id='choice_159_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_35_4' id='label_159_35_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_37\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Psychiatry:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_37'>\n\t\t\t<div class='gchoice gchoice_159_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='1'  id='choice_159_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_37_0' id='label_159_37_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='2'  id='choice_159_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_37_1' id='label_159_37_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_37_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='3'  id='choice_159_37_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_37_2' id='label_159_37_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_37_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='4'  id='choice_159_37_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_37_3' id='label_159_37_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_37_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='5'  id='choice_159_37_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_37_4' id='label_159_37_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_38\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >General medical:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_38'>\n\t\t\t<div class='gchoice gchoice_159_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='1'  id='choice_159_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_38_0' id='label_159_38_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='2'  id='choice_159_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_38_1' id='label_159_38_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_38_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='3'  id='choice_159_38_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_38_2' id='label_159_38_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_38_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='4'  id='choice_159_38_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_38_3' id='label_159_38_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_38_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='5'  id='choice_159_38_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_38_4' id='label_159_38_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_39\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Hematology\/oncology:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_39'>\n\t\t\t<div class='gchoice gchoice_159_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='1'  id='choice_159_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_39_0' id='label_159_39_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='2'  id='choice_159_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_39_1' id='label_159_39_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_39_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='3'  id='choice_159_39_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_39_2' id='label_159_39_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_39_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='4'  id='choice_159_39_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_39_3' id='label_159_39_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_39_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='5'  id='choice_159_39_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_39_4' id='label_159_39_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_41\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Intensive care:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_41'>\n\t\t\t<div class='gchoice gchoice_159_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='1'  id='choice_159_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_41_0' id='label_159_41_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='2'  id='choice_159_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_41_1' id='label_159_41_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_41_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='3'  id='choice_159_41_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_41_2' id='label_159_41_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_41_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='4'  id='choice_159_41_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_41_3' id='label_159_41_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_41_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='5'  id='choice_159_41_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_41_4' id='label_159_41_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_40\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Palliative care:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_40'>\n\t\t\t<div class='gchoice gchoice_159_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='1'  id='choice_159_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_40_0' id='label_159_40_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='2'  id='choice_159_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_40_1' id='label_159_40_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_40_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='3'  id='choice_159_40_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_40_2' id='label_159_40_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_40_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='4'  id='choice_159_40_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_40_3' id='label_159_40_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_40_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='5'  id='choice_159_40_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_40_4' id='label_159_40_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_159_42\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Physical\/Cognitive Rehabilitation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_159_42'>\n\t\t\t<div class='gchoice gchoice_159_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='1'  id='choice_159_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_42_0' id='label_159_42_0'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='2'  id='choice_159_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_42_1' id='label_159_42_1'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='3'  id='choice_159_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_42_2' id='label_159_42_2'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_42_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='4'  id='choice_159_42_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_42_3' id='label_159_42_3'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_159_42_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='5'  id='choice_159_42_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_159_42_4' id='label_159_42_4'>5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_159_43\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_43' >What interests you most about the opportunity to intern at UAB Medicine?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_159_43' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_159_44\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_44' >Discuss your strengths as related to an internship with a medical music therapy program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_159_44' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_159_45\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_45' >Discuss your weaknesses as related to pre-clinical experience and music therapy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_159_45' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_159_47\" class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" >Please include with your application:\n<\/br>\n<\/br>\n<ul>\n<li> Copy of your most recent r\u00e9sum\u00e9<\/li> \n<li>Copy of your most recent transcript<\/li>\n<li>One letter of recommendation and eligibility for internship from your professor or academic advisor<\/li>\n<li>Names and contact information for two additional references<\/li> \n<li>Link to videos of you performing four songs (details below*)<\/li>\n<\/div><div id=\"field_159_46\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='gform_browse_button_159_46' >Resume, Transcript, Letter of Recommendation, References upload<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_159_46' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_159_46&quot;,&quot;container&quot;:&quot;gform_multifile_upload_159_46&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_159_46&quot;,&quot;filelist&quot;:&quot;gform_preview_159_46&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/uabforms.hs.uab.edu\\\/blogs\\\/greyform\\\/?gf_page=d61af79efd0b180&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/uabforms.hs.uab.edu\\\/blogs\\\/greyform\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/uabforms.hs.uab.edu\\\/blogs\\\/greyform\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed 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<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button id='gform_browse_button_159_46' class='button gform_button_select_files' aria-describedby=\"gfield_upload_rules_159_46\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gform_fileupload_rules' id='gfield_upload_rules_159_46'>Max. file size: 8 MB.<\/span><ul class='validation_message validation_message--hidden-on-empty gfield_validation_message gform-ul-reset' id='gform_multifile_messages_159_46'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_159_46'><\/div><\/div><div id=\"field_159_54\" class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" >Please record yourself performing four songs: three on guitar and one on piano. One song performed on guitar should utilize fingerpicking. Please send links to these videos via email with your application. These songs should be from each of the following four genres:<br>\n<ul>\n<li>Country<\/li>\n<li> Gospel\/hymns<\/li>\n<li>Contemporary\/pop<\/li>\n<li> Rock<\/li>\n<\/ul><\/div><div id=\"field_159_48\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_48' >Country Link<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_48' id='input_159_48' type='url' value='' class='large'    placeholder='https:\/\/' aria-required=\"true\" aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_159_53\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_53' >Gospel\/hymns Link<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_53' id='input_159_53' type='url' value='' class='large'    placeholder='https:\/\/' aria-required=\"true\" aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_159_55\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_55' >Contemporary\/pop<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_55' id='input_159_55' type='url' value='' class='large'    placeholder='https:\/\/' aria-required=\"true\" aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_159_56\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_159_56' >Rock<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_56' id='input_159_56' type='url' value='' class='large'    placeholder='https:\/\/' aria-required=\"true\" aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_159_57\" class=\"gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" >Please Note: If we accept you for this internship, we will follow up regarding required health immunizations and potential areas of improvement, to be discussed prior to the internship start date\n<\/br>\n<\/br>\nFor questions regarding UAB\u2019s National Roster Music Therapy Internship Program, please email Aria Mandt at <a href=\"mailto:aegrosso@uabmc.edu\">aegrosso@uabmc.edu<\/a>.<\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_159' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_159\"]){return false;}  if( !jQuery(\"#gform_159\")[0].checkValidity || jQuery(\"#gform_159\")[0].checkValidity()){window[\"gf_submitting_159\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_159\"]){return false;} if( !jQuery(\"#gform_159\")[0].checkValidity || jQuery(\"#gform_159\")[0].checkValidity()){window[\"gf_submitting_159\"]=true;}  jQuery(\"#gform_159\").trigger(\"submit\",[true]); 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