Vancouver EMDR Therapy, PLLC
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Prescreener
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Thank you for your interest in Vancouver EMDR Therapy. Corinne Sudduth, LICSW, currently has telehealth openings. Please complete this brief, confidential prescreener to help her understand your needs. Session and fee information is included, along with the option for a complimentary consultation to see if it’s a good fit.
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What mental health concerns or treatments have occurred in the past or are occurring currently? (Check all that apply)
Currently in therapy
Previously in therapy
Currently taking psychiatric medication(s)
Previously took psychiatric medication(s)
Currently or recently hospitalized for mental health reasons
Hospitalized for mental health reasons in the past
Currently experiencing suicidal thoughts or ideation
Experienced suicidal thoughts or ideation in the past
Suicide attempt (past or recent)
Engaging in self‑harming behaviors (current or past)
Known neurological condition impacting mental health
Known genetic or developmental condition impacting mental health (e.g., ADHD, autism spectrum, learning differences, or other neurodivergent conditions)
Known neurologic condition impacting mental health (e.g., traumatic brain injury, concussion, seizure disorder, chronic migraine, or other brain or nervous system conditions)
Other mental health concerns or treatments?
What is your reason for seeking EMDR therapy? (Check all that apply)
Trauma or PTSD (single-incident or complex)
Childhood or developmental trauma
Anxiety or chronic worry
Panic attacks
Depression or low mood
Dissociation (feeling detached, numb, or unreal)
Emotional regulation difficulties or mood swings
Stress, burnout, or overwhelm
Grief or loss
Somatic or body-based symptoms related to stress or trauma
Chronic pain, chronic illness, or medical conditions impacting mental health
Eating disorders, disordered eating, or body image concerns
Attentional difficulties or concentration problems
Sleep difficulties or nightmares
Relationship or attachment concerns
Addictions or substance use concerns
First Responder or frontline work-related stress
OCD, rumination, or intrusive thoughts
Psychotic features or symptoms (hallucinations, delusions, disorganized thinking)
Mood disorders (e.g., bipolar disorder)
Hormonal, reproductive, perinatal, or postpartum concerns
Life transitions or major life changes
Feeling “stuck” or seeking personal growth
Other
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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