OUCH Chapters are local groups of clusterheads who have organized to facilitate personal contact and communication among themselves.  They are affiliated with the national organization but operate independently.  The OUCH Bylaws, the Articles of Incorporation, and the Annual Charter for OUCH Chapters govern them.

At the present time, there is a moratorium on the formation of new OUCH chapters. OUCH hopes to once again offer members the chance to form their own regional chapters sometime in the future.