Request for Therapy

For victims of a qualifying incident/disaster:

Confidential EMDR trauma therapy is available for First Responders (and their family members) who have responded to a recent critical incident/tragedy or community man-made or natural disaster in Fairfield County.

These services will be provided by Connecticut State licensed mental health professionals who have been specially trained in early EMDR intervention for traumatic events or disasters.

Please complete the form below and a therapist will contact you.

Note: This form will be sent via email and only be seen by the coordinators of FCTRT Inc and the assigned therapist.

If you are unable to complete the form, please contact:

Michael Crouch, LCSW, FCTRT Inc co-coordinator:
Phone: 203-961-1152

Request for Therapy Form