EMDR Consultation Application

Fill out the form below to inquire about my EMDR Consultation Services. I or a member of my team will be in touch you soon.

Name

Preferred Pronouns

Address

Phone Number

Please select which format of consultation you are interested in.

Have you completed your EMDR Basic Training?

In what type of setting do you work?

What types of clinical presentations do you treat?

When were you trained in EMDR? Who was your EMDR trainer?

Are you certified in EMDR?

If certified, who was your consultant for certification?

Have you taken any other EMDR trainings (eg FLASH, DeTUR, RTEP)?

Are there any other clinical modalities you incorporate into your work (Eg CBT, DBT, Sensorimotor, IFS, ego state)?

How comfortable do you feel in providing EMDR?

What are your goals for EMDR consultation?

Is there anything else you want for me to know about you?

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