contact 2 | Robert Safion, M.Ed.

Thank you for your interest in my specialty practice. Please note, that I am presently prioritizing treatment of OCD, doubting and checking sub-types, unwanted sexual, harm obsessions and Contamination-Washing as well treatment for travel/transport agoraphobia related to panic and Fear of Flying related to both fear of accidents and/or Panic

Before proceeding, please read through my Approach page as well as the sections describing the condition(s) that you are seeking treatment for. Your responses, will help me decide whether we would move on to setting up a brief telephone screening.

Please note that sensitivity to diversity, inclusion, social justice, reproductive rights, gender equality, LGBTQ+ rights and gender fluidity are respected and protected in this practice.

First and Last Name

Reason for inquiry

How did you learn of my practice? Direct search? Through another platform? Recommendation?

Cell Phone

Country of Residence

If you live in the US, what is your state of residence

Employed or Student. If you are a student, what is your major and year of graduation

Current living situation

Partner and or family Status

Age

20-30

30-40

40-50

50-60

60+

If Seeking treatment for OCD, please describe symptoms, age of onset, current severity or type N/A

If seeking treatment for another type of Anxiety Disorder, please describe in detail and include impact and severity or type N/A

After reading through my website, in what way do you think my approach could be helpful?

Have national and/or world events concerned you or contributed to your anxiety or negativelystate of mind in any way?

Please describe current use of alcohol or any other substance

Additional comments

UN-DOUBT

reasoning solutions

for

obsessions - fears - imaginary shadows

Age