• About The Applicant

    Information about the person filling out this form.
  • Do you live at the same residence as the hoarder?*

  • Does the hoarder consider themselves a perfectionist?*

  • Does the hoarder avoid making decisions?*

  • Does the hoarder have a compulsive urge to acquire?*

  • Does the hoarder have an emotional attachment to the items collected?*

  • Can the hoarder use furniture for the intended purpose?*

  • Can hoarder prepare food in the kitchen?*

  • Can the hoarder shower/bathe in their bathroom?*

  • Can the hoarder sleep in their own bed?*

  • How difficult would it be for emergency personnel to move equipment through the home?*

  • Does the hoarder live by themselves?*

  • Are there pets in the home?*

  • Are you currently seeking medical care for OCD/depression/ADHD?*