top of page
Countryside Road_edited.jpg

MQ EMDR Intensive Form

Please fill out the form below, and our office will reach out to you.

Intensives: Not covered by insurance. You may be able to submit out-of-network claims for potential reimbursement based on your insurance benefits.

Payment: Must be completed before scheduling is confirmed.

Payment options include credit cards and Afterpay.

Cost for a 3-Hour EMDR Intensive Session:
3-Hour Intensive Session (includes 1-hour follow-up one month later): $1,997
Additional Follow-Up Sessions: $200/hr

Refund Policy: No refunds. Only 1 reschedule permitted.

Preferred method of contact Required
Please select one
Are you currently in individual therapy?
If you are currently in therapy, have you talked with your primary therapist or healthcare provider about participating in an intensive session?
EMDR Intensives are only offered Thursday- Sunday (Depending on availability). Will this work with your schedule?
Are you currently experiencing any severe mental health crises (e.g., psychosis, severe depression with suicidal ideation)?
Do you have any unmanaged medical conditions that could interfere with your therapy sessions?
Do you have any untreated substance abuse issues?

By checking the box below, you understand that due to circumstances such as limited availability and/or the reasons for which you are seeking services, this form is not a guarantee of services.

Information Submitted!

bottom of page