Application for Brainspotting Consultant

Application for Approval as a Brainspotting Consultant

"*" indicates required fields

Name*

Degree*

Professional License type*

Licensing State and number*

Work address:*

Email*

Phone*

Place of employment or practice*

Highest level of education*

Years of experience as a licensed practitioner*

Institution awarding highest degree*

Date of Initial Certification

Initial Certification Consultant

Date of most recent Re-Certification

Recertification Consultant

Date of acceptance as Consultant-in-Training

Date of Completion of Consultant-in-Training course

Trainer for Consultant-in-Training Course

Adjunct Consultant-in-Training Assessment Trainer

Specializations in Brainspotting Practice

Please attach your Trainer’s Report and Recommendation for Approval as a Brainspotting Consultant to your application.

Trainer’s Report

Max. file size: 2 MB.

Initial Approval fee is $50, payable to Brainspotting Trainings, LLC

Initial certification fee

Price:

Total:

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

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Continuation (renewal) of Approval is required every 2 years.
It is expected that every applicant for Continuation of Approval will meet or exceed the minimum standards required for initial Approval as a Brainspotting Consultant, will engage in their own ongoing training and consultation in Brainspotting, and demonstrate knowledge and practice expertise in the most current theory and practice evolutions of Brainspotting.
Continuation of approvaal requires one successful, 60-90 minute assessment with a Brainspotting Trainer, completion of any mutually determined “Continuation of Readiness” plan, and completion of the Application for Continuation as an Approved Brainspotting Consultant
The fee for Continuation of Approval as a Brainspotting Consultant is $50