Thank you for submitting your Clinical Video. Please provide us with the following information about your session. After you click on the SUBMIT button, you will be redirected to a page where you can upload your video directly to our secure website.

Clinician's Name

First Name

Last Name

Clinician's Bio

A brief bio

Client's Name

Include AKA if requested

First Name

Last Name

Additional Clients in Session

Client's Age (years and months)

Client's Gender

Disorder (primary and secondary if appropriate)

One Sentence Overview

Please provide a one sentence description to include with the video thumbnail.

Description of the client/session

Please include any information that you think might be helpful to students watching this video.