OCD Research Study Interest Form

If you’re interested in participating in Rogers' OCD research study that takes place in Brown Deer or Oconomowoc, Wisconsin, please complete the form below. To participate, you must be between the ages of 18 and 65 and not currently receiving treatment for OCD, but can be on a stable dose of medication for 90 days.

Please read the following questions:

Do you deal with unwanted thoughts you just can’t get out of your head?

  • Contamination 
  • Religious 
  • Doubting 
  • Sexual 
  • Need for Exactness and Symmetry

Do you keep repeating behaviors to decrease your anxiety?

  • Washing
  • Checking
  • Counting
  • Repeating
  • Ordering and Arranging
  • Mental Rituals

If you answered YES to either of the questions above, please provide the following information so we can contact you regarding potential enrollment in our study. Your information will NOT be shared with anyone else without your permission or except as required by law. You may contact us directly at any time at 414-865-2600.

Required
Required
Required

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