Agency Name


Dear Judy Cabeceiras:

I am a licensed clinician at AGENCY X and clinical supervisor for J. Doe.  I recommend and support J. Doe for basic training in EMDR therapy.  J. Doe is an MFT intern and works 20 hours a week at our agency.  J. Doe provides therapy to individuals at our agency.  J. Doe is eligible for training in EMDR therapy and will be seeking licensure.

I support their participation in the basic training in EMDR therapy offered by Judy Cabeceiras.  I understand that Judy Cabeceiras will be providing consultation services only and will not be entering into a clinical supervision role.  I retain sole legal and professional oversight for the appropriateness of all psychotherapy services provided by J. Doe at this setting.


Clinical Supervisor Name

Clinical Supervisor License and License Number