Consultation Form

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Consultation Form

I am interested in *

Individual EMDR Consultation for Certification

Private Group EMDR Consultation for Certification

Private Group EMDR General Consultation

Other EMDR Consultation

If Other, please explain

If selecting "Private Group EMDR Consultation", answer

I am part of a group of 2 or more therapists who are interested in forming a private group. Their names are:

Have you taken an EMDRIA Approved EMDR Basic Training Course? *

First Name *

Last Name *

Email Address *

Phone *

What population(s) do you primarily work with? What areas would you like to grow in for your EMDR consultation? *

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