Address:

Name:
City:
Phone:
Cell:
Zip:
E-Mail:
Physical Address of Encounter:
Number of Occupants:
Address:

Years at Location:
City:
Zip:
  Names of Occupants at Location
Gender
Age
1
2
3
4
5
6
7
8
Is there any accounts of paranormal
phenomena that occurred at your
previous residence? If so, explain:
Have any of the occupants encountered any of the
following? (Check all that apply.)
Voices:
Smoky
Forms :
Smells:
Cold/Hot
Spots:
Shadows
Orbs
Explain:

Mood Changes
Strong
Random
Thoughts
Conversations
Explain:

Disappearing/  Moving Objects
Electrical Disturbances
Rappings/ Knockings:
Door Openings
Explain:

Problems With Appliances:
TV
Radio/Stereo
Alarm Clock
Computers
Microwave
Other
Recent Death of
Loved Ones
Give Info:
Recent
Anniversaries,
Birthdays,
Events, etc...
Give Info:
Puberty or
Emotional Stress
of  Adolescence
in area:
Give Info:
Physical  
Contact or
Sexual Attacks
by Apparitions:
Give Info:
Give Info:
Renovations in
Location:
Explain in detail the Paranormal Encounter(s) you
experienced. Include Time, date and locations of the
encounter(s)
Would you be interested in NorCal Paranormal Investigators,
Inc. Conducting an on-site interview and investigation? If yes,
explain why and how you feel we could be of help.
Encounters Questionnaire
FORM CREATED BY RICK REHM
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electronically, how it is collected, how it is used and to whom it is or may be disclosed.  NorCal Paranormal Investigators, Inc. has
developed this online privacy policy to address those questions.  At no time will your personal information that we collect be used by or
sold to a third-party.  Information is solely collected for paranormal research by NPI investigators. We hereby inform you that from time to
time we may send out a newsletter to the email address provided in the NorCal Paranormal Investigators, Inc. questionnaire but beyond
that there will be no unsolicited correspondence from us or any third party from the information provided on this questionnaire.
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NPI does not charge clients for our services, however  
donations are always welcome and greatly appreciated
.