Zoom in on EFIT and Trauma Additional 12-hour Training with ICEEFT Trainer Dr. Leanne Campbell and host Robin Williams Blake

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

First Name *

Last Name *

Name you would like on your ICEEFT Certificate of Completion *

Professional Designation *

Location of Practice *

Level of EFT training *

No previous EFT training (Except Level One EFiT)

Externship

Core Skills

Certified Therapist

Certified Supervisor

Certified Trainer

Guest

Required

Are you a member of ICEEFT? *

Yes

Please let us know the dates, name(s) of trainer(s), and location of your EFiT level one training. *

Confidentiality Agreement: I agree to keep confidential the personal identifying information of case materials shared in this training. I agree not to record any part of this training in any format (audio or video). Personal written notes of non-confidential material are permitted. *

I agree

I disagree

Because this training is online, I agree to make sure that no one else can see my screen or hear the training. If there is a live session, I will wear headphones or earbuds and make sure that I am alone during the training. *

Agreed!

I have the training and educational qualifications to legally practice as a licensed professional mental health practitioner in the area I live OR I am in formal training to be a licensed professional mental health practitioner. *

Yes.

Other:

Required

I understand I can purchase CEUs for this course. The fee for CEUs is approximately $40 (USD) through R. Cassidy Seminars. I understand that if I miss a portion of the training, I must watch the segment I missed before the next training date to keep up with the training experience in order to receive CEUs. Please put me on a list and send me the link to purchase CEUs at the end of the training. *

Yes, I would like CEUs

No thank you.

I am aware that I can watch the recordings of this training until December 31st at no extra cost. *

Yes I am aware.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms