Completion of EMDR Therapy Training
Submission of documentation of 10 hours of EMDR Therapy Consultation
Name
*
First Name
Last Name
Email
*
example@example.com
License Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Part 1 Start Date
*
-
Month
-
Day
Year
Date
Part 2 Start Date
*
-
Month
-
Day
Year
Date
I confirm that I have completed the necessary EMDRIA Quiz in my Part 2 training portal (ONLINE TRAINEES ONLY)
*
Yes
N/A (in-person trainee)
I confirm that I have read the required reading to complete this course (as listed in Required and Recommended Reading and Resources)
*
Yes
Dates/Hours of Consultation
*
Please attach documentation of consultation
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