Consultation Form — The Western New York Trauma Collaborative

Consultant / CIT Bio Form for Website, please fill out and hit the submit button below. Please email kristinadduci@kristinadduci.net, a picture to include with bio.

Name

First Name

Last Name

Licensure

Town

Phone/ Contact

Bio, please limit to one paragraph

Website

EMDRIA Listing URL

Consultant Level

CIT

EMDRIA Approved Consultant