Name: __________
'Stroke Sounds'
Music Listening Diary
BOOKLET: Weeks 1–4

Start date: ___________________
Finish date: __________________

Listening to your favorite music after having had a stroke has been shown to help your recovery.

For this program you will need to listen to 1 hour of music each day for 6 days a week through the MP3 music player we have supplied. Overall this will be for 12 weeks.

Please take the time to fill out this diary every day. It is very important that this information is accurate.

Each day fill out the date and tick whether you have completed listening to your 1 hour of music or not. The comments box can be filled in if you have listened to more or less than the hour we would like you to listen to on the MP3 music player.

When you have finished this booklet you will need to return it to us by mail in the postage paid envelope supplied.

A new booklet will be supplied to you by post for weeks 1–4
At the end of 12 weeks you will need to return your music player to Dr

____when you have your appointment to see him. Your appointment is:

DATE:____________________________

A member from our team will call you to organize a home visit after you have completed the 12 weeks of music listening. This person will ask you some questions to look for your improvements since the stroke. Some participants we have tested have not listened to music, so it is very important that the person that visits does not know whether or not you have participated in listening to music daily.
This person will then contact you around 6 months after your stroke to ask you some further questions.