EMDR Canada

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Membership*
- Professional
- Retired
- Student
- Associate
Contact Info
Name*
First Last
Mailing Address*
Street Address Address Line 2 City Privince Postal Code
Phone*
Email*
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Professional Information
Degree*
Profession*
Registering Association*
License #*
Registering Province*
I confirm that while being a member of EMDR Canada I will: / Je confirme que pendant que je serai membre d'EMDR Canada, je :*
- Hold a membership in good standing with my regulatory body / Détiens une adhésion en règle avec mon organisme de réglementation
-Hold professional liability insurance / Détiens une assurance responsabilité professionnelle
- I declare that these above conditions will continue to be met during the time I am a member of EMDR Canada. / Je déclare que les conditions ci-dessus continueront d'être respectées tant que je serai membre d'EMDR Canada.
EMDR Training
EMDR Designation*
If you would like to add another designation, please contact us after completing this form.
- EMDR Basic Training
EMDR Basic Training Date*
Date Format: MM slash DD slash YYYY
Membership
Members Directory*
- List me in the directory
- Do not list me in the directory
Keep me informed of future workshops and trainings*
- Yes
- No
Journal EMDR Practice & Research
(Online journal is free)
- Printed journal
Preferred Language*
- English
- Français
REGIONAL COORDINATORS PROJECT
The Regional Coordinators are volunteers for EMDR Canada who organize group meetings of trained EMDR therapists for the purpose of sharing information and supporting each other. If you are interested in becoming a Regional Coordinator, a Board Member will contact you. / Les coordonnateurs (trices) sont des bénévoles pour EMDR Canada qui organisent des groupes de rencontre avec des thérapeutes formés en EMDR et ayant comme but le partage d’information et l’entraide. Un membre du CA vous contactera dans le cas où vous désirez devenir coordonnateur(trice).
- Yes, I am interested in becoming a regional coordinator in my area. / Oui, je suis intéressé à devenir coordonnateur régional dans ma région.
- No thanks, I am not interested in becoming or continuing as a regional coordinator. / Non, je ne suis pas intéressé à devenir ou rester un coordonnateur régional.
Member Directory
The information you provide here will be displayed in the member directory. Only fields marked with an asterisk are required.
Street Address
Apt/Suite/Office
City*
Province*
Postal Code*
Required Qualifying Proof
Students: Please provide a copy of full-time student registration. All other members please provide a copy of your EMDR L2 Training Certificate.
I will provide this via:*
- Upload
- Fax
- Mail
EMDR L2 Training Certificate*
Accepted file types: jpg, gif, png, pdf.
Registration Education Institute*
(full time)
Accepted file types: jpg, gif, png, pdf.
Fax Instructions

514-522-1565
Mailing Instructions

EMDR Canada
CP 47527 MTL CP Plateau Mt-Royal
Montreal, QC H2H 2S8
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Mailing Instructions

EMDR Canada
CP 47527 MTL CP Plateau Mt-Royal
Montreal, QC H2H 2S8
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MEMBERSHIP

Membership runs from November 1st till October 31st.
Join us or renew your membership.

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EMDR Canada
CP 47527 MTL CP Plateau Mt-Royal
Montréal (QC) H2H 2S8

Tel: (514) 522-1555
Fax: (514) 522-1565

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