First Name * |
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Last Name * |
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Street Address * |
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Apartment/Suite |
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City, State Zipcode * |
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E-Mail Address * |
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Birthdate * |
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Phone Number (With Area Code) * |
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Best Time to Call |
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How Long Have You Lived/Worked At This Location? * |
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Religion of Occupants/Employees?
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Do You Have Any Pets? * |
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Are Pets Affected By The Activity? |
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Ages & Occupations of residents or employees *
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Has a Ouija Board or other device been used at this location? * |
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If Yes, Please Describe
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How do the occupants feel about the activity? * |
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Is anyone experiencing any type of extreme emotional stress? * |
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Please describe if your answer was yes
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How often does the activity occur? Does it occur at the same times daily, weekly, or yearly? *
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Does the activity seem to focus on one person or only happen when they are present? * |
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If "yes" please list name, age, and details of what occurs:
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Have You Experienced * |
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Does the Activity Coincide With * |
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Have You Noticed * |
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Please explain any answers above and tell us your story in your own words * |
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Are There Electrical Problems In This Location * |
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Are There Structural Problems In This Location * |
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Are There Plumbing Problems In This Location * |
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Have You Contacted Any Other Groups * |
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If So, Which Groups Did You Contact? |
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Will It Be A Problem For The Investigation To Occur Overnight? * |
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Would You Prefer To Be Contacted By E-Mail Or Phone * |
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If you Have An Audio File or Photograph, You Can Attach It Here |
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If you Have An Audio File or Photograph, You Can Attach It Here |
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