Dakota County Paranormal Society
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If you think you are having paranormal activity in your home please fill this application out and we will contact you and also if you are using a mobile device please click on desktop at the bottom of the screen or u wont be able to click the yes or no and also we will not start a investigation until we come to your home and do a home interview. Our services are free including the investigation.
Contact Name:
Address:
City:
Phone Number:
Email Address:
Number of occupants (How many Male, Female, and Children please include ages)
Occupants Occupation(s):
How long have been at this location?
History of location(Year Built,Previous Owners)
Any additional historical information?
How many rooms?
Any Recent Remodeling? Yes
No
If yes, when and what areas?
Did the activity begin during or after remodeling? During
After
Were you made aware of any activity prior to moving in? Yes
No
If yes, by who?
Do you have a religious preference? Yes
No
If yes, affiliation and place of worship:
Has anyone in the residence used a Ouija board or participated in a séance in the residence? Yes
No
If yes, who and when?
Did activity start after this? Yes
No
Do you have pets? Yes
No
Do your pets behave strangely in certain areas of the house or at specific times? Please explain.
List any witnesses who have experienced activity
What types of activity? Banging
Tapping
Footsteps
Shuffling
All of above
What types of activity Banging
Tapping
Footsteps
Shuffling
All of the above
None of the above
If any checked above please describe in detail. (Locations, times)
Have you heard any voices? Male
Female
Children
None of the above
If any checked above please describe in detail. (Locations, times, what was said)
Any Odors? Perfume
Sulfur
Ammonia
Cigar or cigarette
Flowers
Other
None of the above
If any checked above please describe in detail. (Locations, times)
Objects Moving? Yes
No
If yes, what was moved and where?
Objects missing, then reappear? Yes
No
If yes, what, when, where?
Do you see shadows or apparitions? Shadows
Apparitions
None of the above
If yes describe in detail
Please select all that apply Touching
Physical Harm
Feeling of being watched
Feeling of dread
None of the above
Describe any of the above..
Please check all that apply Hot Spots
Cold Spots
Electrical Problems
Plumbing Problems
None of the above
Describe any of the above. When, where
Is anyone having nightmares or trouble sleeping? Yes
No
Does anyone have feelings of nausea at time or in certain locations? Yes
No
If yes; who, when, where?
Describe the first occurrences that happened, when and where.
Does anyone feel threatened? Yes
No
Do you feel that there is paranormal activity and why do you feel this way?
Has a member of the clergy been contacted? Yes
No
Has the location been blessed? Yes
No
If so when?
Have any media sources been contacted or made aware of the activity? Radio
Television
Local Cable
Local Newspaper
Other Newspaper
Other Paranormal Groups
None

Name of media contacted, may we contact this person? (list name and phone)
Are all occupants in agreement as to what is occurring? Yes
No
Is there any occupants who use illegal mind altering drugs or prescription medication that would cause one to believe paranormal activity is at play? Yes
No
If yes, please describe.
What do you wish for D.C.P.S. to accomplish for you?
Is there any additional information you think may be helpful?

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