1. Information Packet (Chicago area only)
   Includes your choice of OCD Guide(s) indicated below and lists of local treatment providers and support groups.
2. Information Packet (outside Chicago area)
   Includes your choice of OCD Guide(s) - select below.
   For a list of treatment providers outside the Chicago area, visit www.ocfoundation.org and click on Find Help.

1. Relief from OCD – A Guide for People with OCD
2. How to Help Your Child - A Parent’s Guide to OCD
3. Got OCD? A Guide for Teens
4. Overcoming OCD: A Guide for College Students
5. School Personnel: A Critical Link in the Identification, Assessment, and Treatment of OCD in Children and Adolescents
   by Gail B. Adams, Ed.D.
   (limited quantity available)

Please specify below. Providing this information will help us customize your Information Packet.

1. Student - Grade School
   Age:
2. Student - Middle School or High School
   Age:
3. Other
   Please Specify:

1. What is the primary OCD symptom (or why do you believe this student or individual has OCD)?
   
   

1. Teacher
2. School Social Worker
3. School Counselor or Psychologist
4. School Nurse
5. School Administrator
6. Other School Personnel
7. Parent
8. Relative
   Please Specify:
9. Other
   Please Specify:

* = Required

1. *Name
   
2. School Name
   
3. *Street Address
   
4. Street Address 2
   
5. *City
   
6. *State
   Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
7. *Zip Code
   
8. *Email Address
   
9. Phone Number
   

Please tell us how you found out about the OCD Education Station

1. Web search
   
2. Newspaper or magazine
   
3. Radio
   
4. Television
   
5. Doctor or other professional
   
6. Family member
   
7. Co-Worker
   
8. Friend
   
9. Other
   Please Specify: