EMDR Consultation Questionnaire 
Hello, Congratulations on your goal to develop your skills as an EMDR therapist.  I am excited to discuss how I may be able to assist you. Please complete the questionnaire below to help me develop a better understanding of your training, current skills, and professional goals as they relate to EMDR. ~Jessica Snyder, LCP, CIT
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Email *
Full Name  *
Licensure/Credentials *
How many years have you been in practice? *
Where are you currently practicing ? *
What type of services are you currently providing and what is your primary population of clients? *
EMDR training provider that provided your basic training course:  *
Which training sessions have you completed? *
Required
How did you complete your training? *
Required
How did you complete your training? *
Required
When did you complete your training? *
Required
Was your training provided by an EMDRIA approved trainer? *
How many EMDR sessions have you held thus far? *
What are your goals for incorporating EMDR into your practice? *
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