Online EMDR Training Participant Addendum

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Please enter the email address, first and last name you will use to register for the training.

Email *

Your First & Last Name *

I plan to attend the Online EMDR Training *

RELEVANT INFORMATION

The participant acknowledges that she/he/they has thoroughly and carefully read, understands, and agrees to the following additional information regarding participation in Online EMDR Therapy Training.

1. Technical Requirements
The participant will adhere to the Online EMDR Therapy Training Technical Requirements on www.EMDRtrainingcenter.com and have the minimum hardware and software prepared and available, prior to and during the virtual EMDR training event.

Video Cameras During Virtual EMDR basic trainings, trainees must have their cameras turned on so that training faculty can monitor attendance, visual cues, facial expressions, etc.

Private/Confidential Space The participant will attend the virtual training from a therapeutic environment, without another person present, not in a moving vehicle, not in a public space.

2. Malpractice Insurance
Prior to admittance to an EMDR training event, the participant agrees to review their own Malpractice Insurance policy to determine whether or not his/her services will be covered and to consider any limitations or jurisdictional restrictions which may be in place.

3. Current Capacity Level
Potential registrants who themselves, or a member of their household or family, are currently experiencing high levels of traumatic stress (i.e. in treatment for life-threatening medical conditions like COVID 19) are advised to consider their own capacity. While the EMDR Therapy training is designed to help regulate the intensity of exposure, the nature of the content and exercises may exacerbate current levels of stress.

4. Safety/Backup Plan
The participant will provide the phone numbers of one personal emergency contact (for example - friend, neighbor, or family member) and one local emergency response agency (for example - local crisis hot line or police). All training facilitators will be performing reasonable safety checks. The participant will give their consent, at a facilitator’s discretion, for any EMDR Training Center staff to call the participant’s emergency contacts, on their behalf.

Please check the boxes below to acknowledge: *

I have read the above information.

I will adhere to the Online EMDR Therapy Training Technical Requirements during the training.

I have taken into consideration my current level of traumatic stress.

Required

Please fill in Your Emergency Contact Information

Personal Contact Name (Family member or friend we can reach if we lose you during the training and can't reach you directly.) *

Personal Contact Phone Number (For Personal Contact listed above.) *

Local Emergency Contact Name (Local emergency response group. We won't use this unless we lose you during practicum and can't reach the personal contact you listed above.) *

Local Emergency Contact Phone Number (Do not enter 911. Enter local area code and the phone number of the group listed above.) *

Please type your name to acknowledge your consent to participate in the Online EMDR Training here: *

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