New England Center for OCD & Anxiety New York

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Please fill out this form, and our clinic manager will get back to you as soon as possible to schedule your free phone consultation to see if we can best support you or your loved one's needs.

Please note we only provide virtual services at this time.

Virtual treatment for OCD and anxiety is just as effective as in-person care. Research consistently shows that evidence-based therapies like CBT and ERP delivered via telehealth produce symptom reductions comparable to face-to-face treatment, with high satisfaction and lasting results. For many clients, virtual care also improves access, flexibility, and real-world application of skills.

Name (person seeking treatment)
*

Name of person filling out this form (if different)

Date of Birth (of person seeking treatment)
*

YYYY

Email
*

Phone Number
*

As your primary insurance, do you receive Medicare, Medicaid, or another federally funded insurance?
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Yes

Gender
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Male

Female

Non-binary

Prefer not to say

Other:

Home Address
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Why are you seeking out services?
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Which services were you seeking? *

General Outpatient Services (Virtual: individual, group, family, and couples therapy options)

Intensive Outpatient Program - "IOP" (Virtual: for clients seeking/will benefit from more frequent sessions)

Group Therapy (Virtual)

Unsure what is best option for person seeking services

Required

How did you hear about New England Center for OCD and Anxiety New York?
*

Have you been given a diagnosis from a mental health professional?

If yes: what, by whom, and when?

Do you have any specific questions about our programs?

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