EMDR-HAP Consultation Information

Name *

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Email *

Phone Number *

Can this number receive texts? *

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HAP Trainee # *

This is a 5 digit number assigned to you by the EMDR Humanitarian Assistance Program

License Information *

If you are independently licensed, please enter your designation and license #; if you are practicing under a supervisor’s license, please enter their name and license info

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Group Consultation
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