Request EFT Supervision
If a Supervisor is available at one of your selected times, they will reach out to youdirectly to schedule a session with you.
Today's Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
I would like to request supervision from:
*
Please Select
EFT Supervisor ($160/hour)
EFT Supervisor Candidate ($100/hour)
Either/First Available
Your First Appointment Choice
*
Your Second Appointment Choice
*
Your Third Appointment Choice
*
I understand that this is not for actual emergencies (need to report abuse, actively suicidal client, etc).
*
Yes
I understand that this supervision can’t be counted as hours toward certification or licensure.
*
Yes
I have liability insurance and will provide proof of insurance if requested.
*
Yes
Request Supervision
Should be Empty: