Name *

First Name

Last Name

Phone

(###)

###

####

Level of EFT Training

Preliminary

Externship

Core Skills

Certified

Supervisor-in-Training

Supervisor

EFIT Level I

EFIT Level II

Interests

I am an EFIT therapist & want to connect with other EFIT therapists

I am interested in a peer EFCT consultation group

I am interested in a peer EFIT consultation group

Do you want to meet in-person?

yes

no

don't care