Questionnaire

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OCD Questionnaire

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Demographics

I am:

Male Female

Age:

Fears of Contamination

1. I find it difficult to touch an object when I know it has been touched by strangers or other people.
Describes me:

A lot A little Not at all

2. I avoid using public toilets because I am afraid of contamination and contagious disease such as AIDS.
Describes me:

A lot A little Not at all

3. I sometimes have to wash or bathe simply because I think I may be dirty or have become contaminated.
Describes me:

A lot A little Not at all

4. I am more concerned than most people about potential contamination with things such as asbestos, radiation, toxic chemicals or household cleaners.
Describes me:

A lot A little Not at all

Ritual Behavior

5. I feel obliged to follow a particular order in dressing, undressing and washing myself.
Describes me:

A lot A little Not at all

6. I check and recheck locks, water faucets, light switches or appliances after turning them off.
Describes me:

A lot A little Not at all

7. I return home to check doors, windows, drawers and cupboards in order to make sure they are properly shut.
Describes me:

A lot A little Not at all

8. I feel the need to repeat routine activities such as going in/out a door or getting up/down from a chair.
Describes me:

A lot A little Not at all

9. I avoid colors ('red' means blood), numbers ('13' is unlucky), or names (those that start with 'D' signify death) that are associated with dreaded events or unpleasant thoughts.
Describes me:

A lot A little Not at all

	Insomnia
	ADHD
	Addiction
	Schizophrenia
	Anxiety
	Eating Disorder
	Panic
	Bipolar Disorder
	Depression
	OCD
	General Mental Health

Disorders and Conditions

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OCD Questionnaire

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Fears of Contamination

Ritual Behavior

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