The Austin Center for the Treatment of
Obsessive-Compulsive Disorder PLLC

Adult Forms

Everyone should download and read the following four forms. You can print them out if you like, but it's not necessary.

 

            ~Limits of Confidentiality

            ~Privacy Practices (HIPAA)

            ~Directions & Map to AustinOCD

            ~YBOCS Instructions

 

Everyone should download, print, and fill out the following four forms:

 

            1 Client info (Adult)

            2 Adult Checklist of Concerns

            3 OC Symptom Checklist

            4 YBOCS

 

If you have had previous outpatient psychotherapists (psychologists, psychiatrists, counselors, etc.), download the following form, print as many copies as you need, and fill them out. Use your judgement in deciding which therapists might be useful for us to talk to. We are generally not going to ask them for written records, but we may want to talk with them briefly on the phone.

 

            Authorization for Release of Info - Outpatient

 

If you have ever had a psychiatric hospitalization, download, print, and fill out the following form. (If there have been multiple hospitalizations, please fill out a separate copy for each one.) This will authorize their releasing records about your hospitalization to us.

 

            Authorization for Release of Info - Inpatient

 

If you think you may have body dysmorphic disorder (BDD), also download, print, and fill out the following two forms. Note that you will be filling out two different forms of the YBOCS. Try to use the regular YBOCS to record the symptom severity of your OCD concerns that are not BDD-related; and use the BDD-YBOCS to record the symptom severity of your BDD concerns.

 

            BDDE-SR

            BDD-YBOCS

 

If you live far from Austin, or if you live closer but are interested in Intensive Outpatient Treatment, download and read the following two forms. You can print them out if you like, but it's not necessary.

 

 

            ~Hotel List

            Contract for Intensive Treatment

 

The sample contract is just for your information at this point and does not need to be filled out yet.

 

Returning the forms to us

 

If you are coming to AustinOCD for regular, outpatient treatment (typically weekly sessions), you can just bring the forms with you to your initial session. (If you prefer, you can send them to us as indicated below.)

 

If you are coming to AustinOCD for Intensive Treatment, please return the forms you have filled out, either by

            Fax to 512 637-5578; OR

            Snail mail to AustinOCD, Highway 290 East, Suite 300, Austin, TX 78723; OR

            Scan them into your computer (preferably as a pdf) and email them to brooke@austinocd.com.

 

 



Click here for Child Forms