Let's connect

If you are interested in an EMDR intensive, please complete the form below. I will contact you to discuss your needs, answer initial questions, and arrange a consultation if an intensive may be appropriate for you.

Please avoid including highly sensitive personal or medical information in this form.

EMDR Intensive Inquiry Form

First Name

Last Name

Email Address

Phone Number

What is leading you to seek an EMDR intensive at this time? Please provide a brief description. You do not need to share a detailed trauma history or other sensitive information.

Would you like me to contact you about scheduling a consultation?

Yes, by phone Yes, by email No, I am only requesting information at this time

What days and times are generally best for me to reach you? Please include your time zone if you are outside Massachusetts.

May I leave a voicemail identifying myself and my practice?

Yes No

The required consultation fee is $100. EMDR intensives are private pay and are not billed through insurance.

Submitting this form does not establish a therapist-client relationship or guarantee that an EMDR intensive will be clinically appropriate.

This form is not monitored continuously and should not be used for emergencies. If you are experiencing an immediate mental health emergency, call 911, go to your nearest emergency department, or call or text 988 to reach the Suicide & Crisis Lifeline.

Let's connect

EMDR Intensive Inquiry Form

Let's work together