Exit this survey OCD In The Classroom 1. OCD In The Classroom Question Title * 1. Do you have had a child with OCD? Yes No If yes, how old was your child at OCD onset? Question Title * 2. Are you a kid or teen with OCD? Yes No If yes, how old are you? If you answered yes to EITHER question above, please complete the following. Question Title * 3. Did OCD impact your or your child’s school performance? Yes No Question Title * 4. If yes, how? (check all that apply) Lowered grades Tardiness Absences Trouble at school with teachers Bullying Other (describe) Question Title * 5. How did you find out that you or your child had OCD? (check all that apply) School _____ Parents Pediatrician Internet Books TV Other media (magazine, newspaper articles) Other (describe) Question Title * 6. Did you or your child need help with dealing with OCD at school? Yes No Question Title * 7. If yes, in what areas? (check all that apply) Getting information on how other OCD-affected families have dealt with this Talking with teachers about OCD Talking with other students about OCD Bullying related to OCD OCD Medications Getting accommodations or an IEP (individualized education plan) Getting an appropriate diagnosis Getting treatment for OCD Question Title * 8. What school personnel were most involved in the struggle with OCD in the classroom? Principal _____ Vice principal Teacher Head master Resource room Guidance/adjustment counselor Psychologist Other (describe) Question Title * 9. Who has been the most helpful? Principal Vice principal Teacher Head master Resource room Guidance/adjustment counselor Psychologist Other (describe) Question Title * 10. We are putting together a Pediatric OCD website for kids and teens with OCD, parents and school personnel. What would be the most important information you would like to see on this website? Question Title * 11. Would you be willing to help with the development of the OCD in the Classroom program? Yes Not now, maybe later No Question Title * 12. Are you willing to be further contacted about this? Yes No Question Title * 13. If yes, please provide below: Name Email Address Mailing Address Phone Number Done