EMDR Consultation

Complete the form below and you will be contacted via email to schedule consultation to get started on becoming EMDR Certified!

Name

First Name

Last Name

Phone

(###)

###

####

Have you completed EMDR Basic Training?

Yes

Not Yet

What service are you interested in scheduling?

Individual Consultation

Group Consultation

If group consultation is selected, please provide individual(s) that will be scheduling with you.

Each group member will need to complete this form separately.

What is your availability during the week for consultation?

How did you hear about us?