Incident Report Form Questionnaire If you would like to report a strange or unexplained experience please describe the incident below, complete the required fields, and submit. All information submitted will be kept confidential and will never be shared without express written consent. Name First Last Optional. You may leave this blank or use a pseudonym if you would like.Email* Please describe your experience*Describe your experience in as much detail as you would like.Has anything like this happened to you before or since the incident described above? Or, have you had any other strange / unexplained experiences at all (even if seemingly unrelated)?*YesNoMaybe / Not sureIf you answered "yes" or "maybe" to the above question, please describe your experience:Would you describe yourself as at all psychic, intuitive, or spiritually sensitive?*YesNoMaybe / Not sureHas anyone in your family had any unusual or unexplained experiences, or undergone anything that might be described as paranormal or supernatural?*YesNoMaybe / Not sureIf you answered "yes" to the question above, please tell us the family relation (e.g., mother, father, child, grandparent, etc.) and the nature of their experience.Do you have any religious beliefs or affiliation?*YesNoIf "yes" to the above question, to what church or religious affiliation do you belong?Check all that apply. Have you...?* Been involved in any with Satanism Participated in occult rituals Practiced New Age beliefs and principals Practiced or attempted magic or witchcraft Used a Ouija board Used Tarot cards Used New Age crystals Participated in palm reading Consulted a psychic or spiritual medium Attempted to communicate with spirits Collected occult objects Attempted to communicate with unknown creatures (e.g., Bigfoot) Participated in paranormal investigations Regularly viewed pornography Habitually abused drugs or alcohol Suffered any sexual abuse or trauma None of the above Please check any / all that apply to your personal background and experiences.Would you like a reply to this report?*YesNoI will not respond back to you unless you specifically request a follow up to this report.