EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY

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





Attended:  



 

I, approve the hours of .

Consultant's Signature

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Pre WK2 Hours
lock iconUnique Document ID: 19d067079b7119d30ac20c63326bcae2886f07fb
Timestamp Audit
February 15, 2022 11:13 am PDTPre WK2 Hours Uploaded by EMDR Institute - registration@emdr.com IP 68.8.205.99
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
October 18, 2022 2:49 pm PDTEMDR Office - inst@emdr.com added by EMDR Institute - registration@emdr.com as a CC'd Recipient Ip: 68.8.204.160
March 14, 2023 11:09 am PDTEMDR Office - inst@emdr.com added by EMDR Institute - registration@emdr.com as a CC'd Recipient Ip: 68.8.205.99
March 14, 2023 11:18 am PDTEMDR Office - inst@emdr.com added by EMDR Institute - registration@emdr.com as a CC'd Recipient Ip: 68.8.205.99
April 5, 2023 4:43 pm PDTEMDR Office - inst@emdr.com added by EMDR Institute - registration@emdr.com as a CC'd Recipient Ip: 68.8.205.99