Name *

First Name

Last Name

Best Phone Number *

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Interested services: *

Weekly or Biweekly Therapy

EMDR Intensive

ADHD/Autism Assessment

Consultation (for Clinicians and Counselors; please indicate in message if you're seeking EMDR Consultation for Certification/Consultant-in-Training, Supervision, or Case Consultation)

Ohio Supervision Endorsement

By checking this box, I understand that: *

Services provided are teletherapy only (with rare exception) and that I must be physically located in Dr. McCormick's states of licensure to receive services (applies to potential clients interested in therapy and assessment services).

Yes