Where did you hear about our trainings? *

Attendee first name *

Attendee last name *

Phone number *Must be available during training hours. If overseas, please add country code.

Email *Must be available during training hours / outside office hours.

Professional Discipline and Eligibility *

Are you registered as a Mental Health Social Worker with the Australian Association of Social Workers, or in New Zealand with the Social Workers Registration Board? *

Yes

AASW / SWRB Registration Number *

Do you have two additional postgraduate years experience and specialist training in mental health? *

Yes

Are you eligible for membership of AASW and have a minimum of 2-years experience in a counselling role in a mental health setting, or a publicly funded service delivering specialist counselling to clients suffering trauma, and are currently employed in a specialist counselling service, or have been in the last 2 years? *

Yes

What is your AHPRA or New Zealand Psychology Board registration number? *

Are you fully registered? *

Yes

What is your AHPRA registration number? *

Do you have 2 years clinical experience working in the mental health field prior to training? *

Yes

How long have you been practising, and what is your experience so far? (Areas of Interest / Practice / Age Group) *

Do you have additional training and experience in mental health diagnosis, assessment, and clinical intervention / counselling intervention before training, with at least 2 years clinical experience in mental health intervention / counselling work? *

Yes

What is your AHPRA or Nursing Council of New Zealand registration number? *

Are you credentialed by the Australian College of Mental Health Nurses and/or can you demonstrate you meet credentialing standards of the Australian College of Mental Health Nurses? *

Yes

What is your AHPRA or New Zealand Occupational Therapy Board registration number? *

Do you have two additional post-graduate years experience working in mental health and specialist training in mental health? *

Yes

Are you registered with the Psychotherapy and Counselling Federation of Australia (PACFA) as a Clinical member, or as an Accredited Mental Health Practitioner or the Australian Counselling Association (ACA) as a Level 3 or 4 member? *

Yes

If in New Zealand, are you registered with the Psychotherapists Board or the New Zealand Association of Counsellors as a Level 8 member? *

Yes

Are you a senior member of ANZACATA? *

Yes

Have you applied for Exceptional Circumstances to Train? (Via https://emdraa.org/are-you-eligible/) *

Yes

If you have received approval, please forward a copy of that approval to drgillianmaddock@emdraustralia.com.au

What are your qualifications? *

How long ago did you complete basic training?

Do you give consent for your email to be included in an open group email when the entire group is contacted for training purposes?

Yes

Testing

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Related store items

EMDR Institute Basic Training : Part 2 (In-person)

EMDR Basic Training : Refresher (Online)

EMDR Institute Basic Training : Part 1 (Online)

Access the course materials