Investigation Request

Investigation Request
To ensure a safe and effective investigation, the Susquehanna Investigators of Paranormal Activity (SIPA) want to gather as much information as possible AND provide you with the information that will prepare you for the investigation.

Please carefully review, and provide us with, the information requested.

If you have any questions at all - please email us at believe@susqparanormal.org
Contact Information

Who is completing this Request?
Name*

First NameLast Name
E-mail Address:*
example@example.com
Phone Number*

Area CodePhone Number
Does this mumber accept text messages?*

YesNo
When is the best day/time to contact you?*
Incident(s) Information

What has been happening?
Please describe the incident(s)*
Please describe the most recent incident(s) - please include date(s)*
Who at the location has experienced incident(s)?*
Has anyone at the location had similar experiences at other homes or locations?*

NoYesOther
If yes, please provide more information
Has there been any media coverage of the incident(s)?*

NoYesOther
If yes, what media source and what was the topic?
Do the incident(s) have a pattern (for example, the same time every night, only when it rains, etc.)?*

NoYesOther
If yes, please describe the pattern(s)
Do the incident(s) occur in a specific area (for example, the kitchen, master bedroom, basement, etc.)*

NoYesOther
If yes, please describe the area(s)
Have you attempted or contacted any of the following to help explain or debunk the incident(s)?*

Psychic or MediumClergySéanceOuija BoardTarot CardsPendulumDowsing RodsCrystalsParanormal InvestigationPolicePhysicianNone of theseOther
If yes, please describe the outcome(s)
Site Information

Where is the investigation?
Address (where the investigation is requested)*

Street Address

Street Address Line 2

CityState

Zip Code
What is your "relationship" to this location?*

OwnerTenantAuthorized RepresentativeOther
How long have you lived/worked at this location?*
What year was the location built?*
How many live (or work) at this location and what are their ages?*
We understand that you may want to be present during the investigation. However, the purest evidence-collecting investigations occur when the homeowner(s) and family are not present and the numbers are kept small. We request that no more than 2 adults, and no one under the age of 16, be involved in the investigation.
What is the approximate square footage of the location?*
Is there adequate parking for 2 large vehicles (truck, van, etc.) and 2 sedans?*

YesNoOther
Are there any historical events associated with this location?*

NoYes
If yes, please describe the history (flood, murder, fire, etc.)
Is there more than 1 building at this location?*

NoYes
If yes, how many and please describe them
Please indicate if the location has any of the following:*

PowerHeat/Air ConditioningDog(s)Cat(s)Bird(s) Reptile(s)BasementAtticOther
Are there any recent (or planned) renovations to the location or the surrounding area?*

NoYesUnknownOther
If yes, please describe the renovations
Additional Helpful Information

...just to confirm...
Is (has) anyone involved...*

having trouble sleepingexperiencing nightmaressleep walkinghad changes in appetitepregnantmedically compromisedmentally illhad a change in medication(s)addicted to alcoholaddicted to legal or illegal drugsrecently entered a recovery program for addictionrecently divorcedrecently added to their family (birth, adoption, foster, etc.)recently lost a loved-onerecently lost a petrecently marriedrecently movedrecently had a job changerecently marked the anniversary of a death of a loved oneregularly (or recently) purchase items from a garage sale or thrift storerecently inherited an itemparticipated in the occultNone of theseOther
What would make an investigation a "success"? What do you want as an outcome? *
Our role is to investigate paranormal activities you are experiencing and provide you with the evidence or information we find regarding those activities. While we can present any evidentiary findings – we cannot perform exorcisms, bless houses, remove paranormal entities from your home or business, or perform any protection rituals for your home or family. Any of these items mentioned should be handled by trained and certified professionals with that area of expertise.
Read, understand and acknowledge

...BEFORE you submit this Investigation Request...
By typing my name here First Name* Last Name* and choosing SUBMIT, I do hereby affirm and confirm my understanding of the following:
All the information I have provided in this Investigation Request is true and correct to the best of my knowledge and that I understand and agree to the provisions identified below.

The Susquehanna Investigators of Paranormal Activity (SIPA) are not demonologists or exorcists and cannot rid a house of entities (paranormal or otherwise).

SIPA's goal is to research and investigate the incidents and activity I have described and to provide evidentiary proof of findings (as available).

In consideration of the use of the premises at the locations(s) identified on this Investigation Request, I for myself, my heirs, personal representative or assigns, do hereby release, waive, discharge, and covenant not to sue Susquehanna Investigators of Paranormal Activity, it’s trustees, directors, officers, employees and agents from liability from any and all claims including negligence resulting in personal injury, accidents, or illnesses (including death) and property loss arising from use of the premises.

Assumption of Risk

I have read the previous paragraphs and I know and understand and appreciate these and other risks are inherent in the activity I am participating in and agreeing to. I hereby assert that my participation is voluntary and that I assume all such risks.

Indemnification and Hold Harmless

I also agree to indemnify and hold harmless Susquehanna Investigators of Paranormal Activity, its trustees, directors, officers, employees and agents from any loss, liability, damage or cost they may incur due to the presence of the undersigned or such children in, upon or about the premises identified above, or in any way observing or using any facilities or equipment of the Susquehanna Investigators of Paranormal Activity or participating in any program affiliated with the Susquehanna Investigators of Paranormal Activity whether caused by the negligence of the releases or otherwise, including attorney fees as a result of this use of premises.

Severability

I expressly agree that the forgoing waiver and assumption of risk agreement is intended to be as broad and inclusive as is permitted by the laws of the United States of America and the Commonwealth of Pennsylvania and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

Permission for Use of Image, Likeness and Video

I for myself, my heirs, personal representative or assigns, do hereby release and grant the rights to the use of any image, likeness, and video obtained during the use of the premises listed above.

Acknowledgement of Understanding

I have read this Investigation Request (including the aforementioned waivers and agreements) and fully understand its terms.

I acknowledge that, by submitting this Investigation Request, I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
www.susqparanormal.org believe@susqparanormal.org www.facebook.com/Susqparanormal

The Susquehanna Investigators of Paranormal Activity (SIPA) is recognized by the Internal Revenue Service (IRS) as a 501(c)3 non-profit organization (FEIN 45-5315618)
Should be Empty:

Investigation Request

Contact Information

Incident(s) Information

Site Information

Additional Helpful Information

Read, understand and acknowledge

By typing my name here First Name* Last Name* and choosing SUBMIT, I do hereby affirm and confirm my understanding of the following:

www.susqparanormal.org believe@susqparanormal.org www.facebook.com/Susqparanormal

The Susquehanna Investigators of Paranormal Activity (SIPA) is recognized by the Internal Revenue Service (IRS) as a 501(c)3 non-profit organization (FEIN 45-5315618)