Hillcrest Patient Form – YBOCS form for OCD

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This form is strictly confidential and is encrypted with a SSL certificate on a secure server. We never share your information with any third parties. Alternatively you can download a copy of the form and submit it to adminhillcrest@ketamind.co.za.

A copy of your results will be emailed to KetaMIND Clinics South Africa. Should your score indicate you are severely obsessive-compulsive, we may contact you to discuss available treatment options, including but not limited to KCSA Infusion Therapy.

This form is to be filled in prior to coming in for treatment.

    Obsessions are frequent, unwelcome, and intrusive thoughts.

    1. How much time do you spend on obsessive thoughts?





    2. How much do your obsessive thoughts interfere with your personal, social, or work life?





    3. How much do your obsessive thoughts distress you?





    4. How hard do you try to resist your obsessions?





    5. How much control do you have over your obsessive thoughts?





    Compulsions are repetitive behaviors or mental acts that you have a strong urge to repeat that are aimed at reducing your anxiety or preventing some dreaded event.

    6. How much time do you spend performing compulsive behaviors?





    7. How much do your compulsive behaviors interfere with your personal, social, or work life?





    8. How anxious would you feel if you were prevented from performing your compulsive behaviors?





    9. How hard do you try to resist your compulsive behaviors?





    10. How much control do you have over your compulsive behaviors?





    Total scores

    Your score

    If you have both obsessions and compulsions, and your total score is;

    8-15 = Mild OCD; 16-23 = Moderate OCD; 24-31= Severe OCD; 32-40 = Extreme OCD

    No single test is completely accurate. You should always consult your physician when making decisions about your health.