subject_line
MFPS Investigation Request Form
Hello, and welcome to the Munroe Falls Paranormal Society investigation Request System. This form is designed to guide you through the process of requesting assistance from MFPS for paranormal issues that you may be experiencing. The form takes about 15-20 minutes to complete. The more detail you can provide us, the better we will be able to assist you with your paranormal situation. All answers are kept strictly confidential and will never be discussed outside of MFPS.
Please begin here:
First Name:
*
Last Name:
*
Street Address:
*
City:
*
State:
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zipcode:
*
Primary Email Address:
*
Home Telephone Number:
*
Mobile Telephone Number:
*
Your Gender:
Male
Female
Your Age Group:
under 10
11 - 20
21 - 30
31 - 40
41 - 50
51 - 60
61 - 70
71 - 80
81 - 90
over 90
Your Race/Ethnicity:
🛈
African American
Asian
Caucasian
Hispanic
Native American
Other
Please detail the type of activity you are experiencing:
How long has the activity been going on for:
Less than a Month
1-3 Months
3-6 Months
6-12 Months
1-3 Years
3-5 Years
More than 5 Years
How many people live or work at this location:
*
Are there children present or involved?
*
Yes
No
If "Yes" to previous question, How many children are in the household:
How many people aside from yourself have witnessed activity?
Provide a brief description of what others have experienced if possible:
Please list any pets or animals that you have in the house:
Please list all medications that you or your family may be taking at this time:
Has there ever been a history of mental illness with you or a family member?
*
Yes
No
Has there ever been a history of drug abuse with you or a family member?
*
Yes
No
If "Yes" to either of the above questions please explain in detail:
Do you live close to or within 1000 feet of any high tension power lines?
*
🛈
Yes
No
Please list all other unusual activity:
- Unexplained Footsteps
- Loud Banging Sounds
- Tapping or Knocking
- Scratching Sounds
- Unusual Cold Spots
- Unusual Hot Spots
- Dark or Light Shadows
- Heavy Feeling on the Upper Body
- Nausea and Dizziness in Certain Rooms
- Unexplained Psychical Injuries
- Doors & Cabinets Opening or Closing
- Lights Turning On or Off
- Unusual Battery Drain on Portable Devices
- Items Disappearing & Reappearing
- Strange Animal Behavior
- Feelings of Being Watched
- Feelings of Being Touched
- Faint Voices, Cries or Whispers
- Moving or Levitating objects
- Strong Impressions to Leave a Room
- Unusual Smells (Burning or Sulfur like smells)
Should an investigation be warranted, MFPS only allows family members to be present during an investigation. If in the workplace, only active employee's will be allowed to be present. Do you agree with this policy?
*
Yes
No
Should an investigation be warranted, MFPS requires any air contaminates such as smoking, perfumes, aerosols, fireplaces & etc. to not be used 6 hours prior to the investigation. Do you agree to this policy?
*
Yes
No
Once an investigation has been scheduled, it is the homeowner's or company's responsibility to secure any animals or pets that may place a team member in danger of injury or impede the investigation. Do you agree with this policy?
*
Yes
No
If you have any photos, videos or audio files that you feel can help us with our investigation please attach them to this form.
If you uploaded any media, please describe what you feel is relevant to these photos, videos or audio files:
Powered by
Report abuse