Donation Form

Please consider a monthly or one-time gift to the EMDR Research Foundation. Your donations will allow the Foundation to promote health and growth of human beings through the support of quality research, evidence-based practice and compassionate, well-informed clinicians.

Ways to Give

Join the Visionary Alliance — Recurring donations can be made in the amount of $15 or more and scheduled for your convenience.
Single Donation — A one-time donation can be made in any amount.
By Mail — Complete the Printable Donation Form and mail it to:
EMDR Research Foundation
207 E. Ohio Street #430
Chicago, IL 60611

Contact Information

First Name: Last Name: Donor Name 2: Company: Email: Phone: Address: City: State: Province (Foreign) Zip Code: - Country: Donation Level:

$15

$25

$50

$100

$250

Other Amount

This is a one-time donation

Make this a recurring donation deducted

Donor Note:

If you'd like to create a fund/fundraising page, please contact us at info@emdrresearchfoundation.org!

Available Funds (optional): Honor or Memory: In Honor/Memory of:
(please provide name if applicable, or put "N/A") Acknowledgement Letter (sent to the honoree or family member)
Name: Address: City: State: Zip Code: - Country: Email:

Billing Information

Payment method: Credit Card
American Express

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Cardholder First Name: Cardholder Last Name: Billing Address: City: State: Zip Code: - Country:

NOTE: Please only click the 'SUBMIT' button once. Your payment may take time to process.