Register For A WebEMDR Account

Agreement to terms of use
Terms of UseDescription of Study Participants in this study are asked to complete a brief questionnaire while reflecting upon a specific unpleasant past experience. They are then presented with a series of various visual stimulations on their home computer. The study is concluded with a series of brief questionnaires. The study will take approximately ten minutes and be conducted in the privacy of one's own home and on one's own home computer.Statement of Confidentiality All information submitted to WebEMDR.com and WebEMDR LLC is confidential. Any information submitted to WebEMDR.com and WebEMDR LLC is used solely to evaluate on-line techniques for the relief of anxiety, stress, depression, and posttraumatic stress disorder. No information of any kind is shared at any time with third parties.Statement of Disclaimer and Limitation of Liability This research study is designed to explore the impact of various on-line interventions on the level of distress experienced by individuals with anxiety, stress, depression or symptoms of post-traumatic stress and/or posttraumatic stress disorder. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately. Participants may experience mild fatigue, boredom, or distress and anxiety recalling traumatic events. Participants may also experience feelings of calm or relief as a result of learning about new techniques for treating anxiety, stress, depression, and posttraumatic stress disorder. By selecting the "accept" box below, you expressly agree that your participation in the WebEMDR LLC study is at your sole election or choice. WebEMDR LLC makes no warranty as to any results that might be obtained from the use of the test site. By selecting the "accept" box below, you hereby release WebEMDR LLC its members, principals, assigns, businesses or other entities in which it has or may have legal or other interests now or in the future, from any and all liabilities, claims, demands, actions, or judgments, that you have or may have arising out of your participation in this research study. You expressly agree that WebEMDR LLC will not be liable for any direct, consequential, or incidental physical or emotional damages, whether foreseeable or not, that may result from your participation in this on-line study. You acknowledge that no therapeutic or professional relationship exists or will arise or exist pursuant to or as a result of your participation in WebEMDR LLC on-line research.

By clicking on the "I wish to participate" button below, I acknowledge that I have completed this questionnaire and understand that the information I submit is confidential and will be evaluated only for purposes of this study.

Yes, I agree to the terms No, I do not agree to the terms

	Problems	1	2	3	4	5
1.	Having upsetting thoughts or images about a past event?
2.	Having bad dreams or nightmares about a past event?
3.	Re-living a disturbing past event or feeling as if it were happening again?
4.	Feeling emotionally upset when reminded of a past event?
5.	Trying to avoid people, places, or things that remind you of a past event?
6.	Not being able to remember an important part of a specific past event?
7.	Having much less interest or participating much less often in important activities?
8.	Feeling distant or cut off from people around you?
9.	Feeling emotionally numb?
10.	Feeling as if future plans or hopes will never happen?
11.	Having trouble falling or staying asleep?
12.	Feeling irritable or having fits of anger?
13.	Having trouble concentrating or staying focused?
14.	Being overly alert and cautious, or hypervigilant?

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WebEMDR Registration

Please provide the information requested below. All information is kept strictly confidential.