Cult Questionaire

You or someone you know may be involved in a cult Since God's Page has come to be, we have had different people cross our path, that we have been in contact with. People that have known and people that are living in a world of darkness. In Hayti, where voodoo is practiced and accepted; in England where one is captive in a cult; here in the United States where a friend's daughter knows of those looking for a way out. The list goes on.
Are you involved in a cult? Do you want out? Maybe it's not you. It's your daughter or a friend. Just remember, you are not alone. There is hope. There is a way out. Will it be easy? No it won't. Will it be worth it? Yes, definitely yes.
There are many ways of looking at what may be and what are going to be hindrances in your walk or your persons walk to freedom. You see, not only do you have a tie in the physical realm, you also have a tie in the spiritual realm.
To follow are a list of questions. You can copy and paste, then email back to us at God's Page . We will help however we can. The person in question, will be known as "your person", be it you or someone else. Answer only the questions that are appropriate to your situation.
Who is involved? ( )You ( )Family Member ( )Friend Please specify: __________________________________________
Age:_________________...Date of Birth:_____________________
If it is someone else, why do you think your person is involved in a cult?________________________________________
______________________________________________________________________________________________
What is your concern?_____________________________________________________________________________
Is your person in school? ( )Yes ( )No Grade?_______ ( )Passing ( )Failing
Does your person work? ( )Yes ( )No What Field? ___________________________________________________________
Have there been reoccuring absenses? ( )Yes ( )No Explain:________________________________________________
Is your person open/talkative? ( )Yes ( )No Is this normal?________________________________________________
Is your person close to the family? ( )Yes ( )No Explain:____________________________________________________
Has there been a recent estrangement? ( )Yes ( )No Explain:__________________________________________________
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Has there been a radical change in your persons behavior? ( )Yes ( )No Explain:_____________________________
__________________________________________________________________________________________________________________
On a scale of 1 - 10, with 10 being the most drastic, how would you rate it?______________________________________
Have you discussed this with your person? ( )Yes ( )No Explain:______________________________________________
__________________________________________________________________________________________________________________
Is your person hyper/relaxed?_________________________ Is this normal?___________________________________________
Any other family members with mental illness?_____________________________________________________________________
Has your person ever attempted suicide? ( )Yes ( )No Explain:________________________________________________
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Is your person self-abusive? (Ex: Cuts self) ( )Yes ( )No Explain:__________________________________________
__________________________________________________________________________________________________________________
Is your person abusive to people? ( )Yes ( )No Explain:______________________________________________________
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Is your person abusive to animals ( )Yes ( )No Explain:______________________________________________________
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Was your person abused as a child or in an abusive relationship? ( )Yes ( )No Explain:_______________________
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Has there been an increased usage of alcohol? ( )Yes ( )No Explain:__________________________________________
Has there been an increased usage of drugs? (Prescription or illegal) ( )Yes ( )No Explain:_________________
__________________________________________________________________________________________________________________
Do you know what is being used? Average intake?__________________________________________________________________
Has your person been to treatment? ( )Yes ( )No For what/when?_______________________________________________
What type of movies/tv does your person watch?____________________________________________________________________
Type of music?____________________________________________________________________________________________________
What type of pictures & posters does your person like? What do they seem to represent?___________________________
__________________________________________________________________________________________________________________
Does blood fascinate your person or scare them?___________________________________________________________________
How does your person react to needles? Knives?____________________________________________________________________
Does your person have frequent nightmares?________________________________________________________________________
Does your person sleep more often? Suffer insomnia?______________________________________________________________
Is this normal?___________________________________________________________________________________________________
Is or has your person been in trouble with the law? ( )Yes ( )No Explain:____________________________________
__________________________________________________________________________________________________________________
Does your person sneak out of the house during the night? ( )Yes ( )No Do you know where or why?_____________
__________________________________________________________________________________________________________________
Is your person religious? ( )Yes ( )No Who does your person worship?_________________________________________
__________________________________________________________________________________________________________________
What makes you think that your person worships who he/she does?___________________________________________________
__________________________________________________________________________________________________________________
What makes you think that your person is in a cult?_______________________________________________________________
__________________________________________________________________________________________________________________
Have you seen sign/symbols that indicate cult activity or other worship? ( )Yes ( )No Explain:_______________
__________________________________________________________________________________________________________________
Has their been a radical change in friends? ( )Yes ( )No Explain:____________________________________________
__________________________________________________________________________________________________________________
Does your person have rituals that he/she performs that you have noticed? ( )Yes ( )No Explain:______________
__________________________________________________________________________________________________________________
Does your person get overly enthusiastic about things? ( )Yes ( )No Explain:_________________________________
__________________________________________________________________________________________________________________
Why do you think your person is involved in a cult?_______________________________________________________________
__________________________________________________________________________________________________________________
Do you know what kind of cult your person is involved in?_________________________________________________________
__________________________________________________________________________________________________________________
How involved? (Ex: interested & checking it out? High Priest?____________________________________________________
Do you know of others involved?___________________________________________________________________________________
Do you know if your person chose to be there or was forced?_______________________________________________________
Are there certain practices involved that we should know about?___________________________________________________
__________________________________________________________________________________________________________________
Are you afraid for your person? ( )Yes ( )No Explain:________________________________________________________
Have you discussed this with your person? ( )Yes ( )No What kind of response did you get?____________________
__________________________________________________________________________________________________________________
Is these opinions yours?__________________________________________________________________________________________
Do they coincide with other family members?_______________________________________________________________________
Have you discussed this with someone in the legal field? ( )Yes ( )No What kind of response did you get?_____
__________________________________________________________________________________________________________________
Have you discussed this with a medical professional? ( )Yes ( )No What kind of response did you get?_________
__________________________________________________________________________________________________________________
How do others around your person feel about these issues?_________________________________________________________
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How does your person react during holidays? Are there any certain ones that seem to affect your person?__________
__________________________________________________________________________________________________________________
What do you think is going on?____________________________________________________________________________________
__________________________________________________________________________________________________________________
What do you think needs to happen?________________________________________________________________________________
__________________________________________________________________________________________________________________
What kind of a person do you think you need to help you see this through?_________________________________________
__________________________________________________________________________________________________________________
Have other family members had cult involvement that you know of? ( )Yes ( )No Who? What?____________________
__________________________________________________________________________________________________________________
Has there been any confrontation with your person?________________________________________________________________
__________________________________________________________________________________________________________________
What kind of reaction did you get?________________________________________________________________________________
__________________________________________________________________________________________________________________
Where does your person live? City _____________________________ State_________ Country_________________________
Do you know if your person has ever tried to walk away? ( )Yes ( )No Explain:________________________________
__________________________________________________________________________________________________________________
Were there threats? ( )Yes ( )No Explain:____________________________________________________________________
Has anyone tried an intervention? ( )Yes ( )No What/when/how:________________________________________________
__________________________________________________________________________________________________________________
Are there binding ties?___________________________________________________________________________________________
Summarize what your needs are and what you would like us to help you with:________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Your Name:________________________________________
Address:
Street:________________________________________
City:..________________________________________
State/Province:________________________________
Country:.......________________________________
Zip/Mail Code:.________________________________
Telephone No:..________________________________
Email Address:.________________________________
Fax Number:....________________________________
Your Persons Name:________________________________
Address: (if known)
Street:________________________________________
City:..________________________________________
State/Province:________________________________
Zip/Mail Code: ________________________________
Country:.......________________________________
Telephone No:..________________________________
Email Address:.________________________________
Fax Number: ________________________________
The reason that all of these questions are being asked is to find out where you think things are and what you think needs to happen. Answer honestly as you can.

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