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Ghosts and Hauntings Reporting Form

GHRS/ParaResearchers/PSICAN Form...

 Do you have a report that's happened within Canada? Do you wish to tell us about it or even request more information about something that's happened to you or someone you know? Although we might not be able to provide answers, your report is vital to our work and would appreciate it very much if you could take a few minutes to fill out the form below...

Please remember: Your information is safe, secure, and private with us. We don't sell, give away, or make public ANY information without express permission to do so. We also do not use or sell any information to "spammers" or marketers. Your privacy and security and most importantly, your comfort are our paramount concern.

GHOSTS AND HAUNTINGS EXPERIENCE REPORTING FORM:




Is this a personal experience or are you reporting someone else's experiences?

My own experience
Someone else's
Both - My own and other's experiences



Was this experience specific to a site/building/area?

Yes
No
Maybe - See details



What province did the main experience happen in?





What major city/town is closest to where this happened?





Did this experience happen in the above mentioned city/town?

Yes


If not, please specify where it happened (town/township/county/etc.)





Were you the only witnesses or the only person who experienced this?

Yes
No
Not sure



If yes (or not sure and applicable,) how many other witnesses were/are there?

One other person
Less than five
More than five
Not sure



Was this an event that happened indoors or outdoors... or does that matter?

Indoors
Outdoors
Both indoors and outdoors
Doesn't matter



Please select below those options that best describe what you experienced or that you know has been experienced particular to this site/event that you feel might have been unexplainable.

Something was seen
Something was heard
Something was moved
Something was smelt
Something was felt (Physical)
Something was sensed



When/What Time did this event happen?

Very Early Morning
Morning
Late Morning
Early Afternoon
Afternoon
Late Afternoon
Early Evening
Evening
Late Evening
None Specific/Happens all the time



If you know exactly (or reasonably approximately) what time this happened, please tell us below...





What was the date when this happened? (If not applicable, please let us know... if "seasonal", just type in the season or time.)





On a scale of 1 through 10, (ten being the strongest) how 'powerful' was this experience for you or those who you're reporting for?





Were you actively looking for an experience or phenomena? (On a tour or doing an investigation?)

Yes
No
Aware of the ghost stories, but not looking.



Did the experience harm you physically or have a person physical affect on you or the (other) witness(es)?

Yes
No
Not sure
Not Physical but Emotional



Are you or the person(s) you're reporting for hoping for a resolution to this in terms of an explanation or "clearing"?

Yes
No
Not sure



Was this event/experience current or ongoing? (Current is within the last six months.)

Yes - Within the last six months
Yes - Ongoing
No



Are you the current owner, tenant, manager or otherwise in possession legally of the site (if applicable) to where the experience happened?

Yes
No
Not applicable



Do you consider yourself psychic or sensitive?

Yes
No
Somewhat



Do you believe that the event or experience was a communication or trying to communicate?

Yes
No
Unsure



Have you attempted or done any of the following (please click/select the applicable...)

Capture the phenomena on film/Digital

Capture the phenomena on tape/digital audio

Capture the phenomena on video

Contact/Communicate with the phenomena via a device (pendulum/ouija board/etc.)

Contact/Communicate with the phenomena via psychical means (medium or psychic)

Clear the area in some fashion (Clearing, Blessing, Exorcising or Smudging)

Historical research on the site/area

Contacted another group about the experience (not GHRS, ParaResearchers or PSICAN)

Done a complete sweep for a natural answer to what's going on

Studied books and/or websites about similar situations

None of the above



If you tried anything above, how succesful was it in your opinion?

Very Succesful
Somewhat Succesful
Not Succesful
Not Applicable
Some efforts have been succesful, some have not



Please briefly explain what the original experience was...



If you've done any study or have a hypothesis/idea of what (or who) might be causing these events, please briefly explain below...





Have you paid out any money(s) for assistance or help with this problem to any source?

Yes
No



Do you wish us to follow up with this report (contact you towards more study)?

Yes
No



If there isn't a PSICAN related group near you and you wish to have a follow up, would you be comfortable with us passing any information on to a trsuted non-PSICAN group or investigator(s)?

Yes
No
Only if you contact me first



If you are the current tenant, owner, manager or otherwise in possession of the site(s) where these events/experience happened, would you be open to a visit from our team?

Yes
No
Perhaps - Need details from us about possible visit



PERSONAL INFORMATION: Please note, we do not sell, give out, or otherwise release any personal information to any parties. The information is for PSICAN group use only and will not be given out under any circumstance beyond our own teams unless otherwise specified. (See below.) We will never "spam" you or sell/give your information out to marketers or spammers or anyone else that will contact you with unsolicited information.

You do not need to fill out the information below, but if you wish to be contacted for a follow-up, please ensure your name and e-mail address (at least) are filled in.

Name:

Age:

If not entering your age, please let us know if you're over 18 years of age...

Yes - I am over 18 years of age.
No - I am younger than 18 years of age.

Address (Street):

Address (E-mail):

Phone number with Areacode (Daytime):

Phone number with Areacode (Evening):

We cannot guarantee a phone call. Our prefered method of contact is e-mail. If using only your phone number, we cannot guarantee any contact will be made so please, use e-mail first.

Are you comfortable with this information (above) being entered into our offline (non-public) database of phenomena and experiences with ghosts and hauntings?

Yes
No

Are you comfortable with us possibly using this information later on for reports or statistical analysis that may be put online on our site? (Please note: Exact addresses, contact information and names are never released publicly.)

Yes
No

Did you wish to contact you on behalf of other users/readers with possible correlating information? (We do not give out any contact information, but should someone else report something that's similar to your report, we would contact you on that person's behalf to possibly allow for an exchange of communications with you and the "new" person... if you wish... but your contact information would remain private unless you request at that time for it to be given to the said "new" person.)

Yes
No

Would you be interested in any live seminars about similar experiences and wish us to contact you when they come up?

Yes
No

Would you like to participate in any private, online discussions of similar experiences and events and let us contact you about them should they come up?

Yes
No

Are you interested in becoming an investigator or researcher in the paranormal in general? (Would require us to contact you later with information...)

Yes
No
I'm already an investigator or researcher with another group or as an independent.

PLEASE RE-READ THE ABOVE AND IF SATISFIED, CLICK ON "SUBMIT" BELOW.

It normally takes about seven days for us to respond to these reports, but we will try to respond as soon as possible.

Unfortunately, in some regions of Canada, we don't have local investigators and researchers so on-site visits and investigations may not be possible at the present time, but we will offer any and all support via e-mail and through other channels that we can.

Also, in some cases, investigations and visits may be difficult or impossible in certain situations. We will try and meet any needs or requests, but sometimes are unable to schedule meetings or perform any investigations in certain situations. If you've requested this, the investigator/researcher will let you know via e-mail if an on-site or visit is possible.

PLEASE NOTE Once you click "Submit", the screen will go white and show your answers. This means the form was sent properly. We DON'T use any "auto-responder" to let you know it's been sent properly (we respond personally within seven days) so please, unless you see an error, only send the form ONCE. When you're done, PLEASE use the BACK button on your browser to return to this page and exit this form with the links provided or via your browser.



All images, text and notes, unless otherwise noted, are the property of PSICAN and may not be used without express permission of this site's management. For permissions to reproduce, link or otherwise use this information, please contact admin@psican.org to gain express permissions.

©2005 - PSICAN
Privacy and Liability Information:

Privacy Information: All information gathered or otherwise gleaned through this website and possible related forms or mail will only be used by the PSICAN website and staff and it's affiliated group(s) for the purpose of information and study towards the paranormal. We will not sell, use, give away or otherwise use your personal information for any other purposes. If you need further information, please contact admin@psican.org for details and/or with questions. (In layman's terms, we won't be telemarketing or "spamming" you mercilessly... your information will stay internal with us only and we won't sell our mailing lists to spammers or "marketers".)

Click Here for a PDF document on our complete privacy policy.

Liability: The owner(s) of the PSICAN site and it's management can not be held responsible for any issues of a technical or personal related context for the use of, reading of, or anything attempted by the user of this site as for it's information and content. PSICAN is also not responsible for the content of external links or information placed on our message board(s). The viewer/reader/user of this site assumes all personal liability and/or any consequences therein with the use of the information and webpage you are viewing.