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EMDR Consultation Request
Please contact me with any questions:
maggiehrlpc@gmail.com
970-689-7692
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Name
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Your answer
Contact info:
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Your answer
When did you complete EMDR Basic Training?
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MM
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DD
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YYYY
Are you planning on using these training hours towards certification in EMDR?
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Yes
No
Maybe
Do you have any hours accrued towards certification?
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No
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Do you want to participate in:
Group Consulation
Individual Consultation
Both
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What is the population you work with most often?
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Your answer
Do you have specific questions you want addressed?
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Your answer
What do you hope to get out of consultation?
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Your answer
What are ideal days and times for your schedule?
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