Contact and Pre-screening Form

Thank you for your interest in my specialty practice. Please note, that I am accepting prospective clients with OCD, phobias, fear of flying or highway agoraphobia related to panic. Presently, I am prioritizing prospective clients, between the ages of 20 and 40, seeking treatment for unwanted, tormenting sexual or harm obsessions and/or doubting and checking OCD. However, I accept clients over 18, seeking treatment for Phobias and/or Fear of flying. For those under the age of 21, I do ask that the person seeking services fill out the form.

Before proceeding, it is important to read through "my approach" page as well as the description of the condition(s) that match your symptoms. This information will be needed to answer the questions that follow. Based on your responses, we would onto next step of setting up a brief telephone screening.

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Please note that diversity, inclusion, social justice, reproductive rights, gender equality and non-binary gender fluidity are welcome in this practice
Pandemic and COVID-19

As an ongoing COVID-19 precaution, remote video sessions are still offered as are in-office meetings with negative pressure ventilation and filtration. Masking is optional per client preference. I do require that all prospective clients be vaccinated and boosted, at least once.

Country of Residence

Employment and Occupation

COVID Precautions [Response Required for both columns]

I am seeking treatment for one or more of the following types of OCD

If you are seeking treatment for OCD or related disorder please describe your obsessions, compulsions and impact on your life

I am seeking treatment for one or more of the following anxiety disorder or conditions

Impact of pandemic and political/international events

Please check any of the following conditions, experiences, behaviors or circumstances that apply even if minor

Below is a list of health insurance plans I accept in Massachusetts. Please indicate if you are covered by one of these or if you will be paying out-of-pocket.

Please indicate how you will be paying for treatment

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© 2023 Robert Safion, M.Ed.

Treatment of Obsessional Spectrum Anxiety

6 Harris Street, Newburyport, MA 01950