Victims: Please use this templet to identify yourself and your trauma

• Female Male
• Trauma started in:
• Victim currently resides in:
• Birthdate: mo/yr only
• Divorced Married Separated Never Married
• # Children Born in early/mid/late 50/60/70/80/90’s
• Mild Harassment started in
• Intense harassment started in
• Type of harassment:
  
  24 hour audio input
  mostly abusive or supportive or both
  Memory blockage
  Mood control
  muscle manipulation
  sleep depravation
  altered environment including
  
  • vehicle sightings
  • animals killed
  • wild rumors spread
  
  
  
  
  

Thank You For Your Participation

Email: consent@usa.net