Request MID Analysis

UPDATE ON 15 November 2021: Please be aware that requests submitted between 11 November and 13 November 2021 via the form below were not received due to an unforeseen issue that arose during a routine website update. The issue has now been resolved, as of 15 November 2021, but there is no record available for requests set during the aforementioned date range. If you submitted a request and did not receive a response, even to a second request, please kindly resubmit your request.  We apologize for this inconvenience. 

Sometimes, response messages to you may be routed to spam/junk or entirely filtered by your email service provider. So, if you've already requested MID Analysis but have not received the email with the access link and password, then please check your 'spam/junk' folder before re-submitting your request. If you still haven't received it, then re-submit your request via this form and click the box that says, '**This is my second request for MID Analysis'. If you don't receive it on the second attempt, please click here to contact the webmaster for assistance.

IMPORTANT NOTE: If you are not a clinician, clinician-in-training, or mental health researcher, then please seek out a qualified practitioner (for example, by CLICKING HERE), who can help you, rather than attempting to diagnose yourself.

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First Name:*

Last Name:*

Degree(s)/Credential(s):*

Mental health clinician-in-training (choose degree/profession below)
MA/MS
MSW
MEd
LMSW/LCSW/LICSW
LPC/LCPC
MHC/LMHC
MFT/LMFT
PhD
PsyD
MD
Licensure/Degree Outside US

Email:*

Re-enter Email:*

Professional License or Registration # (if you are not licensed, type N/A)*

State / Province / Country of Licensure or Registration (if applicable)

Practice, Organization, or Research Institution Name*

I am requesting MID Analysis v5.2 for (choose all that apply):*

Diagnostic/treatment purposes
Clinical/institutional research
To diagnose myself

**This is my second request for MID Analysis

Terms and Conditions:
The MID and MID Analysis are intended for the exclusive use of mental health clinicians-in-training, licensed clinicians, and researchers. To obtain a copy of the MID Analysis, you must be one or both of these, and your intention must be to use MID Analysis for diagnostic or research purposes. You are responsible for your use of the MID and MID Analysis, and agree to hold the authors of the MID, MID Analysis, and related documents free from liability.

By entering my name below, I attest that I am a clinician-in-training, licensed clinician, and/or researcher, and that I understand and agree to the terms of use described above.

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