EMDR Intensive Application
Thank you for your interest in scheduling an EMDR Intensive with me. To begin the process, please complete the form below. Once submitted, I will review your responses and may request additional information to ensure I fully understand your needs before scheduling your discovery call.This is your first step toward creating meaningful shifts in your life, and I'm here to guide you every step of the way.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Intensive Session Type
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Please Select
Individual
Couple
Family
Intensive Location
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Please Select
Online
In Person
Hybrid
Not sure
Intensive Scheduling Preference
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Please Select
Fall 2024
Winter 2024-2025
Intensive Package Type
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Please Select
Week Day
Weekend
Monthly
Unsure
Please share any questions that you would like answered below:
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Please verify that you are human
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