Supervisor Letter

Your supervisee is enrolled in the EMDR Therapy Basic Training and needs you to confirm that they have completed master's level coursework at an accredited school and are on a licensing track. Please provide the following information.

Student Information

Student Intern Name(Required)

First Last

Student Intern Email(Required)

Supervisor Information

Supervisor Name(Required)

First Last

Supervisor Email(Required)

Supervisor License Number(Required)

Supervisor License Type(Required)

Supervisor Signature(Required)

Signing below, indicates that you supervise the work for the above individual

Supervisor Letter

Student Information

Supervisor Information

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