EMDR Institute – Consultation Hours Submission Form

Consultant:  When submitting consultation hours for your consultee, please submit all hours together rather than after each session.  You will have the opportunity to download a copy of the completed form once you hit the SUBMIT button.  The EMDR Institute will receive a copy of your completed form as will your consultee.  Please utilize the comments section if there are extenuating circumstances.  -- Thanks.

EMDR Institute Consultation Hours

Must be completed by an EMDR Institute approved consultant

Consultee Information

In this section, please provide the necessary information about the individual for whom you are approving the hours.

Consultation Sessions

Hours Being Submitted For(Required)
Please submit Post Weekend One and Post Weekend Two separately.
Session information(Required)
Please provide a clear list of the dates and the number of hours for each session. If the sessions span multiple days, use the plus button at the end of the row to add a new line.
Please enter a number from 1 to 6.
Please only submit whole numbers (1, 2, 3, 4, 5, 6)

Consultant Information

Please complete the required fields with your information in this section.
Consultant Name(Required)
Upon clicking the submit button, a PDF report will be generated and sent to both you and the consultee. It is the consultee's responsibility to forward the report to EMDR once they have completed the required 5 hours.