Have You Been Abducted?

Ask yourself if you . . .

1.) Have had missing or lost time of any length, especially one hour or more?
YesNo

2.) Has a sudden sleepiness come over you, at an inappropriate time or when you had not previously felt tired?
YesNo

3.) Have you ever woken up in a different place or position than when you went to bed?
YesNo

4.) Have you ever found leaves, twigs, or other unusual items in your bed, upon waking?
YesNo

5.) Had you been paralyzed in bed, or woken up paralyzed?
YesNo

6.) Do you have unusual scars or marks with no possible explanation on how you received them. especially if you have an emotional reaction to them. (i.e. small scoop indentation, straight line scar, scars in roof of mouth. in nose, behind or in ears, or genitals, etc.) ?
YesNo

7.)Have you seen balls of light or flashes of light in your home or other locations, sometimes looking like a light show?
YesNo

8.) Do you have a memory of flying through the air which could not be a dream, or flying in an unknown craft?
YesNo

9.)Have you any memory of being on a spacecraft or ship?
YesNo

10.) Have seen beams of light outside your home, or come into your room through a window?
YesNo

11.) Have had dreams of UFOs, beams of light, or alien beings?
YesNo

12.) Do you have any memory of medical procedures being practiced on your or someone else?
YesNo

13.) Have had a UFO sighting or sightings in your life.?
YesNo

14.) Have you ever had the feeling you are being watched, especially from above?
YesNo

15.) Do you have a cosmic awareness, an interest in ecology, environment, vegetarianism, or are very socially conscious?
YesNo

16.) Do you have a strong sense of having a mission or important task to perform, without knowing where this compulsion came from?
YesNo

17.) Have had unexplainable events occur in your life, like an angelic visitation, and felt strangely anxious afterwards.
YesNo

18.) Do you have many of these traits but can't remember anything about an abduction or alien encounter?
YesNo

19.) Have you ever had a religious vision or spiritual vision?
YesNo

20.) Have you tried to resolve these types of fears with little or no success?
YesNo

21.) Have you had a dream of eyes such as animal eyes (like an owl or deer), or remember seeing an animal looking in at you? Also, do you have a fear of eyes?
YesNo

22.) Have you awoken in the middle of the night startled?
YesNo

23.) Have you ever felt as if someone tossed you in bed or actually felt someone touching you, grabbing you?
YesNo

24.) Do you have strong reaction to cover of Communion or pictures of aliens. Either an aversion to or being drawn to.
YesNo

25.) Do you have inexplicably strong fears or phobias. (i.e. heights, snakes, spiders, large insects, certain sounds, bright lights, your personal security or being alone, especially a fear of the dark)?
YesNo

26.) Do you stay awake all night and sleep during the day, or have a difficult time sleeping during the night?
YesNo

27.) Have you experienced self-esteem problem much of your life?
YesNo

28.) Do you suffer from any type of neurosis, psychosis, depression or any other mental problem?
YesNo

29.) Are you a religious or spiritual person?
YesNo

30.) Have you seen someone with you become paralyzed, motionless, or frozen in time, especially someone you sleep with.?
YesNo

31.) Have you awoken with marks, burns, scratches, cuts or bruises which appeared during the night with no explanation as to how you could have possibly received them.?
YesNo

32.) Has someone in your life who claims to have witnessed a ship or alien near you or has witnessed you having been missing?
YesNo

33.) Have you had, at any time, blood or an unusual stain on sheet or pillow, with no explanation of how it got there?.
YesNo

34.) Do you have an interest in the subject of UFO sightings or aliens, perhaps compelled to read about it a lot, or on the other hand do you have an extreme aversion towards the subject and dislike discussing it.
YesNo

35.) Have you suddenly been compelled to drive or walk to an out of the way or unknown area?
YesNo

36.) Do you go to a cabin, or have a strong desire to go to one?
YesNo

37.) Are you what they call a "loner"?
YesNo

38.) Have you had dreams of passing through a closed window or solid wall?
YesNo

39.) Have you ever seen someone floating in the air?
YesNo

40.) Have you seen a strange fog or haze that should not be there?
YesNo

41.) Have you heard strange humming or pulsing sounds, and you could not identify the source?
YesNo

42.) Do you have a strange ringing or buzzing in your ear?
YesNo

43.) Have you ever had the feeling you have been "scanned"?
YesNo

44.) Have you had unusual nose bleeds at any time in your life, or awoken with a nose bleed?
YesNo

45.) Have awoken with soreness in your genitals or anal area, which can not be explained?
YesNo

46.) Have you had back or neck problems, T-3 vertebrae out often, sciatic back problems, or awoken with an unusual stiffness in any part of the body?
YesNo

47.) Have you had chronic sinusitis or nasal problems, adenoids, or nasal polyps?
YesNo

48.) Do you still have your tonsils?
YesNo

49.) Is your blood type RH negative?.
YesNo

50.) Have you had electronics around you go haywire or oddly malfunction with no explanation (such as street lights going out as you walk under them, TV's and radios affected as you move close, overheads blow lights, etc.)?
YesNo

51.) Have you seen a hooded figure in or near your home, especially next to your bed?
YesNo

52.) Do you have an unusual fear or dislike of doctors or tend to avoid medical treatment?
YesNo

53.) Have you had insomnia or sleep disorders which are puzzling to you?
YesNo

54.) Do you have frequent or sporadic headaches, especially in the sinus, behind one eye, or in one ear?
YesNo

55.) Have you had the feeling that you are going crazy for even thinking about these sorts of things?
YesNo

56.) Have you kept these fears to yourself for fear of ridicule?
YesNo

57.) Have you had paranormal or psychic experiences, (like deja vu) including intuition?
YesNo

58.) Are you prone to compulsive or addictive behavior?
YesNo

59.) Have you channeled telepathic messages from extraterrestrial?
YesNo

60.) Are you afraid of your closet, now or as a child?
YesNo

61.) As a child did cartoon characters, favourite toys, Santa Claus or dolls appear to you and talk to you?
YesNo

62.) Have you had sexual or relationship problems, (such as a mysterious "feeling" that you must not become involved in a relationship because it would interfere with "something" important you must do?)
YesNo

63.) Do you have to sleep against the wall or must sleep with your bed against a wall?
YesNo

64.) Are you afraid to look out windows or go outside at night?
YesNo

65.) Do you hear strange noises at night, someone on the roof, scratching at the second story window, or someone in the house and when you check no one is there?
YesNo
66.) Do you have a difficult time trusting other people. especially authority figures?
YesNo

67.) Have you had dreams of destruction, war, invasions or natural catastrophes?
YesNo

68.) Have you had the feeling that you are not supposed to talk about these things, or that you should not talk about them?
YesNo

69.) For women only: Have you consistently had late periods, then feel you've had an "experience" and your period begins?
YesNo

70.) For women only: Did you have a hysterectomy at an early age?
YesNo

71.) For women only: Have had false pregnancy or missing fetus. (pregnant, and then not)?
YesNo

72.) Do you believe in the exsistance of Alien beings? YesNo

Could you please fill out my survey on this email form, and send it to me. I am interested in gathering first hand information about Experiencers and those who feel they have never had an experience. I would like to complete a statistical analysis of the data, when a large enough sample size has been gathered. Your personal information will never be published and I only wish to compare the data of the experiencer and the non-experiencer. I am also looking for similarities in those who believe they have indeed had an experience, to see if they have common factors, such as blood types for example. I hope some of you will also be interested in that data and complete my survey. Look for the results soon!!
This survey was designed and programmed by Stephen Daniels

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