Paranormal Activity Questionnaire
Please complete the following questions regarding activity at your property.
Name
*
First Name
Last Name
What is your age?
*
Please Select
Under 18
18-25
26-35
36-45
46-60
60+
Email
*
example@example.com
Type of Property
*
Please Select
Flat
Bungalow
House
Who Lives at the Property?
*
Please Select
Single
With Partner
With Parents/Family
With own family (partner and children)
When did you move to your current property (approx)?
*
-
Day
-
Month
Year
Date
Do you know the approximate age of the property?
Town/City
*
When did the activity start? (Approx)?
*
-
Day
-
Month
Year
Date
Has there been any physical or emotional event that has happened around the start date? Eg Someone dying, illness, someone moving in or out, change to person or property, neighbours etc. (Please leave as much information as possible that may help us)
Type of Activity witnessed.
Please fill in the details for each type of activity. If you haven’t witnessed this type of activity, then please leave blank.
1. PHYSICAL ACTIVITY - When did this type of activity start?
-
Day
-
Month
Year
Date
Please describe the activity and what you have experienced in as much detail as possible?
How often does this activity take place?
Monthly
Weekly
Daily
Several times a day
2. VISUAL ACTIVITY - When did this type of activity start?
-
Day
-
Month
Year
Date
Please describe the activity and what you have experienced in as much detail as possible?
How often does this activity take place?
Monthly
Weekly
Daily
Several times a day
3. AUDIO ACTIVITY (Noises, Voices etc) - When did this type of activity start?
-
Day
-
Month
Year
Date
Please describe the activity and what you have experienced in as much detail as possible?
How often does this activity take place?
Monthly
Weekly
Daily
Several times a day
4. OLFACTORY ACTIVITY. (Smells/tastes) - When did this type of activity start?
-
Day
-
Month
Year
Date
Please describe the activity and what you have experienced in as much detail as possible?
How often does this activity take place?
Monthly
Weekly
Daily
Several times a day
Any other activity not covered above. Please provide as much information as possible.
WITNESSES. Please state if anyone else has seen any of the above activity. Please state which type, when and what happened. (You do not need to give names at this point if you don’t wish to). Please provide as much info as possible.
ATMOSPHERIC FEELINGS. How does the activity feel and what effect is it having on the residents?
None
Occasional
Often
Constant
Oppressive or feeling of dread
Being watched
Sadness
Happiness
Normal
Please upload any evidence you may have. Includes photos, videos or audio.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload any evidence you may have. Includes photos, videos or audio.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload any evidence you may have. Includes photos, videos or audio.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload any evidence you may have. Includes photos, videos or audio.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Is there anything else you wish to add at this point?
Finally, What type of help are you looking for?
Please Select
Who/what is causing the issue.
Removal of issue.
Cause and removal of issue
Other
If other, please state what you would like from us?
…and finally, Why do you think the activity is paranormal and not something normal?
*
Submit
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