EMDR Note Template
A complete clinical documentation bundle designed by Sherly Millan, LICSW, for real EMDR sessions.
Track targets across sessions: Memory/Trigger, Negative Cognition (NC), Positive Cognition (PC), Validity of Cognition (VOC), and SUD scores — all in one clean grid.
Capture each session completely: Safe Place, BLS modality and sets, Cognitive Interweave, SUD baseline and close, Installation, and Body Scan.
Watermarked preview — the downloadable PDF is clean and unbranded.
What's Included in the Bundle
- Negative Cognition (NC) and Positive Cognition (PC) per target
- Validity of Cognition (VOC) baseline and end scores
- Subjective Units of Disturbance (SUD) tracked across sets
- BLS modality, speed, and number of sets
- Cognitive Interweave documentation
- Safe Place, Installation phase, and Body Scan
How to Use This EMDR Note Template
Use this template during each EMDR session to maintain thorough clinical documentation across all 8 standard protocol phases. Begin by recording the target memory and baseline SUD score before desensitization. During processing, note the type of bilateral stimulation used — eye movements, tapping, or auditory tones — along with the number and duration of each set. Track SUD levels after each set to monitor progress. Document any cognitive interweaves you introduce when processing stalls, and record the Positive Cognition and VOC score during the Installation phase. Complete the Body Scan section before closing. For insurance reimbursement, mark the active phase at the top of each note, pair the session with the corresponding CPT code (90837 for 60-minute sessions, 90834 for 45-minute), and reference both SUD movement and VOC progression as objective measures of medical necessity. This documentation structure satisfies AIP-model standards and supports clean payer review.
Insurance-Compatible EMDR Documentation
Structured EMDR documentation supports medical necessity for insurance billing. These templates track AIP-model phase progression and SUD/VOC outcomes — the clinical data payers need to justify EMDR treatment.
Compatible with CPT codes 90837, 90834, and 90847.EMDR Certification Companion
Working toward EMDRIA Certified Therapist status? Keep your sessions, consultation hours, and credits in one organized workbook, with printable forms for the rest of the application.
What's inside the Companion
- Start Here dashboard: your sessions, unique clients, consultation hours, and EMDRIA Credits against the targets (50 sessions, 25 clients, 20 hours with 10 individual, 12 credits)
- Session Log for up to 500 sessions, with automatic session and unique-client counts
- Consultation Log that checks the 5-year window, separates individual from group hours, and applies the Consultant-in-Training cap
- Credits Tracker that flags any entry missing a certificate or approval number
- Application Checklist and a Renewal Tracker for the two-year cycle
- Printable forms, as a PDF for GoodNotes or paper and as editable Word: readiness checklist, consultant letter request, notarized statement worksheet, and consultation prep sheet
Excel workbook (also opens in Google Sheets), plus PDF and Word forms. Instant download.
Built around client ID codes only. Never enter names, initials, or birth dates.
An independent resource from EMDR Unlocked. Not affiliated with or endorsed by EMDRIA, and it does not guarantee certification. Requirements change, so please confirm the current list with EMDRIA before you apply.
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