EmailMe Form - Colorado Coalition of Paranormal Investigators

Name *

First Last

Email *

How Did You Hear About Us? *

Physical Address of Investigation Location *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Please Indicate the Type of Location to be Investigated. *

Are You The Owner of The Property To Be Investigated? *

If "NO" Are You Legally Authorized To Allow An Investigation To Take Place?

How Long Have You Been Affiliated With The Property? *

Have There Been Any Recent Renovations To The Property? *

Please List the Age and Gender of ALL Location Occupants / Employees. *

What Type of Activity Is Taking Place?
(Check All That Apply) *

If You Selected "OTHER", Please Explain.

How Many of the Above-Listed People Have Witnessed the Activity? *

Has Anyone Afiliated With The Property Recently Experienced Any Physical Trauma or Emotional Stress, To Include Puberty? *

Have Any Law Enforcement Agencies Been Contacted Regarding This Matter? *

If Yes, Which Agency?

Do You Believe In Ghosts? *

If "YES" Did You Believe In Them Prior To Your Encounter?

Do You Believe In Psychic Phenomena? *

Has Anyone Affiliated With The Property Had Experiences With Ghostly or Paranormal Phenomena At Another Location? *

If "YES" Please Explain

Has Anyone Affiliated With The Property Had Recent Sleep Disruptions? *

Has Anyone Affiliated With The Property Recently Experienced The Death of A Loved One? *

If "YES" Who and When?

Has Anyone Affiliated With The Property Ever Visited An Alleged Haunted Location Either Alone or With A Group? *

If "YES" Please Explain Who, Where, and When

If The Phenomena You Experienced Was Visual, Did It Move or Was It Stationary? *

If Objects Were Moved, Did You See Them Move? *

If There Was A Sensation of Touch, How Would You Describe It? *

How Did The Phenomena Leave You Feeling? *

Do You Agree With The Teachings of Your Church/Religion? *

How Does Your Church Feel About Ghosts and The Paranormal? *

Have You Contacted A Clergy Member Regarding This Activity? *

Do You Have Any Knowledge About Ghosts and The Paranormal? *

If "YES" Where Does This Knowledge Come From? (i.e. Books, TV, Internet)

Is Anyone Affiliated With The Property Currently Taking Any Medications - Aside From Over-The-Counter Medicines and Birth Control? *

Has Anyone Affiliated With The Property Recently Suffered A Serious Illness or Injury? *

Does Anyone Affiliated With The Property Suffer From Mental Illness? *

Was Anyone Drinking Alcohol or Using Marijuana At The Time of The Experience(s)? *

Has Anyone Affiliated With The Property Used or Experimented with An Ouija or Other "Talking Board"? *

Has Anyone Affiliated With The Property Experimented or Practiced Witchcraft or Black Magic (excluding Wicca)? *

Please Provide Any Additional Information You Feel Might Be Relevant to This Situation.

By checking the box below, I affirm all of the above questions have been answered to the best of my abilities and all were answered truthfully.

I understand that the Colorado Coalition of Paranormal Investigators (CCPI) does not charge for their services and, if it is deemed necessary, may conduct an investigation at the above-listed location at their own expense.

I understand that my identity, along with anyone else affiliated with the property, as well as the address will be kept completely confidential, unless required by law enforcement or legal subpoena.

I understand that, even if an investigation is warranted, my request for services may be denied if the location is not safe for the investigating team (i.e. asbestos, excessive litter or trip hazards, animal waste, possible illegal drug use at the location, potentially violent (living) occupants etc.) and will be advised by a senior CCPI team member if my application is being denied based on these or other conditions.

In checking the box below, I am submitting my electronic signature acknowledging the above-mentioned understandings and authorizing a member of CCPI to contact me regarding the activity I am reporting. *

Electronic Signature