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Standard Interview Form

Thank you for contacting Regional Investigators of the Paranormal (R.I.P.) serving the areas of Kentucky, North Carolina, Northeast South Carolina and Virginia.

Do you have what appears to be a haunting? Are you concerned for your well-being and peace of mind? Please fill out our form below and complete as much information as you can. All information given will be kept in the strictest of confidence and will be seen only by our founder and group managers.

Name: *
Address:
City:
State:
Zip:
E-mail:*
Phone: *
Number of Occupants:
Name(s) and Age(s) of Occupants:
How long at this address?
Approximate age of location?
Number of previous owners?
How many rooms at location?
Has there been any recent remodeling? If so, explain:
History of Location:
Tragedies
Deaths
Previous Complaints
Include any known information below if you checked any of the boxes.
How often does the phenomenon seem to occur?
Have any of the occupants seen apparitions? If yes, please describe.
Do ALL occupants experiencing the phenomenon seem to be in agreement?
Yes
No
Do you feel your safety is in jeopardy? If yes, please explain.
Are any occupants experiencing difficulty sleeping?
Yes
No
Are any occupants experiencing reoccuring nightmares?
Yes
No
Are any occupants currently taking medications?
Yes
No
Has there been any physical contact? If yes, please explain.
Do you have any pets?
Yes
No
If yes, has there been any strange behaviors? Please describe.
Has there been any witnesses to said activity?
Yes
No
If yes, who?
Has media been involved?
Yes
No
If yes, what type(s) of media sources?
Have there been any unexplained odors or aromas, such as:
Perfume
Floral
Sulfur
Excrement
Other:
Have there been any unexplained sounds, such as:
Footsteps
Knocking
Banging
Other:
Have there been any unexplained voices, such as:
Whispers
Shouting
Screaming
Crying
Laughter
Other:
Diplacement of objects? If yes, please describe.
Unexplained phenomenon such as objects floating freely? If yes, please describe.
Books being stacked?
Yes
No
Have there been any drastic temperature changes?
Yes
No
Electricity/Utilities/Plumbing Issues:
Toliets Flushing
Lights going on and off
Kitchen Appliances
Telephone Ringing
Strange Computer Issues
Other:
Do you have any other comments you'd like to share with us?

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