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Your
Name:
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Email
Address:
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Phone
Number (Optional):
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Would
you prefer us to reach you by phone or email?:
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Location
of site (City, State, Country):
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Is the
location currently occupied?:
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Is the
location where the suspected paranormal occurrences are happening occupied?
If so, please list the names (first
name only is fine) and ages of occupants:
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Occupants
religious beliefs?:
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Do the
occupants practice the occult?
(Ouija, Seances,
Spells, etc.):
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Is there
a history of, or mental health diagnosis for occupant?:
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Are any
of the occupants on medication?:
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Any
occupants drink alcohol? To what extent?:
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Are any
occupants having nightmares or trouble sleeping? If so, please describe:
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Age of
site:
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Number
of rooms on site?:
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Do you
have any information about the previous owners or know if they experienced
anything unusual while there?:
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Has
there been any recent remodeling on the location?:
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Any
known previous deaths or tragedies on site?:
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Has
there been any media involvement or previous investigations on the location?:
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Please
describe the events that have taken place at the location in as much detail
as possible with estimated dates and times, frequency of the occurrences and
if there were any other witnesses:
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Describe
the reaction to the occurrences
(i.e.
scared, puzzled, comforted, etc.):
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Have there
been any unusual odors?:
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Any
sounds?:
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Any
voices?:
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Any
movement of objects?:
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Have there
been any electrical (including appliances)
or computer problems?:
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Any
plumbing problems?:
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Have
there been any unusual hot or cold spots?:
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Do the
pets seem affected?:
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Have
there been any touching or physical sensations?:
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What do the occupants believe is happening?
Are all
in agreement?
Do the
occupants feel threatened?:
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What
would the occupants like to see happen concerning the activity? (i.e. want to
make contact, just curious, want it to stop, etc.:
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Are you
interested in a possible investigation?:
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Any
other questions or comments?:
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