Thanks for your interest in attachment-informed EMDR. Please fill in the following form if you would like your details to be passed on to colleagues on our network who may have availability.

Note that by completing this (confidential) form with its basic details, you are giving us permission to store that data on our secure website and to forward your request automatically to a select group of trusted fellow EMDR therapists.

We can’t promise you will hear back, but hope you do. If you make a successful connection, please note that we will encourage your therapist to let us know at EMDR Focus that this is under way, though we won’t ask for any names or further details. 

Note that if you’re looking for EMDR supervision or training, best to contact us directly here, as this form is for clients seeking individual therapy. 

Good luck!

The EMDR Focus team.

5. Client EMDR Request Form

Name
Name

Given

Family

GDPR: I confirm that I am happy for the information in this form to be saved confidentially by EMDR Focus and forwarded automatically by email to EMDR Focus-associated therapists who might currently have availability. I also confirm that these therapists have permission to contact me directly. I also confirm that EMDR Focus/Braynework take no responsibility for any work or connection that may arise through my completing this form. Please note that if you choose no, this form will erase other answers and also not go through to submission. But thanks for your interest anyway – you may want to contact us directly using the separate contact form.

Please indicate your rough age.
How do you wish to work with EMDR? (Tick both if either is OK)

Optional. What days/times work for you? Tick all that apply.
If we have available therapists, how would you like to be contacted? Tick all that apply.

Please indicate how you heard about Braynework/EMDR Focus.