Ivory & Pine Counseling | EMDR Intensive Interest Form

moc.enipdnayrovi%40arual | 720-306-1107

Ivory & Pine Counseling

Ivory & Pine Counseling

moc.enipdnayrovi%40arual | 720-306-1107

EMDR Intensive Interest Form

Your first step toward an EMDR Intensive! I will be in touch with you shortly to set up a consultation call.

What state are you located in?*

Colorado - in person Thornton/willing to travel

Colorado- virtual

Florida

Massachusetts

Nevada

Utah

Washington

Other - help me understand my options!

Do you currently have a therapist?*

Yes

No

Looking

Have you participated in EMDR before?*

Yes

No

Are you hoping to use insurance benefits to offset the cost of your intensive?

Yes

No

Unsure

Tell me more!*

Thank you!

I will contact you within 2 business days to set up a consultation call.

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Ivory & Pine Counseling

Ivory & Pine Counseling