Online Group 2

Online EFT Supervision Lunch Group

Do you live far away from any EFT supervisors?

Would you like to get more supervision at less cost?

Do you prefer meeting at your office?

Perhaps Online Video Conferencing Supervision is for you!

See and share video taped sessions.
Review the model.
Hear the way others use attachment language.
See EFT at work!

You can enjoy the benefits of group consutation at the touch of your finger tips.

                                               This is a photo of Becca's Secure Online meeting room.

MEETING INFORMATION:

When: 2nd and 4th Tuesday of every month
            12 - 1:30 pm PT

Cost:   $125. per month ($42. an hour)

Limited to 4 participants

One month notice to discontinue

Lunch Group Online
(learn to do powerful couple's therapy)
Consultee Information Form

Completing this form indicates your willingness and request to participate in the 2nd and 4th Tuesday EFT Online Supervision Lunch Group.

After you complete this form you will be contact by Dr. Jorgensen or her business manager within 24 hours (on a business day) to confirm your registration to the Online Group.

Payment for supervision is due at or before the time of service and can be made via check or credit card.

For questions call 619-569-2654 or email Dr. Jorgensen at dr.rebecca.jorgensen@gmail.com. She will gladly assist you.

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Please indicate the EFT Training you have completed to date:	Read the Manual
	Completed the Workbook
	Externship
	Advanced Externship
	Core Skills Advanced Training
	Previous Supervision

Location of Externship Attended:
Date of Externship Attendance: Month/Year:
Type of EFT supervision interested in. Enter one.
Comments:	Enter comments here!