Your Name
*
Email
*
Phone
*
Are you filling this out for someone other than yourself?
Yes
No
No elements found. Consider changing the search query.
List is empty.
Person Seeking Care
*
Is the Person Seeking Care over 18?
Yes
No
No elements found. Consider changing the search query.
List is empty.
Is the individual seeking help currently experiencing symptoms of OCD?
Yes
No
No elements found. Consider changing the search query.
List is empty.
Have you ever been diagnosed with OCD by a healthcare professional?
Yes
No
No elements found. Consider changing the search query.
List is empty.
What challenges are you currently facing related to OCD?
Intrusive thoughts or mental compulsions (e.g., unwanted thoughts or images)
Excessive checking (e.g., doors, appliances, locks)
Contamination fears (e.g., excessive washing or cleaning)
Repeated counting, tapping, or organizing
Fear of harming others or oneself
Excessive doubt or need for reassurance
Hoarding or difficulty discarding items
Perfectionism or fear of making mistakes
Ritualistic behaviors (e.g., repeating actions or phrases)
Avoidance of certain situations, places, or people
Moral or religious obsessions (e.g., fear of sinning or being immoral)
(Select all that apply)
What is your current health care situation?
Currently seeing a therapist
Currently on medication
No Treatment
Do you have access to stable internet and a private space for a video consultation?
Yes
No
No elements found. Consider changing the search query.
List is empty.
Submit