EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY

EVALUATION AND CONSULTATION SIGN-OFF FORM

To Be Completed PRIOR to attending Weekend 2 of the Basic Training

EMDR Institute
PO Box 750 Watsonville CA 95077
Phone:  831-761-1040 / Fax: 831-761-1204 / Email: inst@emdr.com





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Signature Certificate
Document name: Pre WK2 Hours
lock iconUnique Document ID: 9c53cf89ad866ff1935485abdd63de393765fb63
Timestamp Audit
February 15, 2022 11:13 am PDTPre WK2 Hours Uploaded by Drew Hendricks - drew.hendricks@nimbletoad.com IP 68.8.204.160
February 16, 2022 1:17 pm PDTDrew Hendricks - drew.hendricks@nimbletoad.com added by Drew Hendricks - drew.hendricks@nimbletoad.com as a CC'd Recipient Ip: 68.8.204.160