Personal Spiritual Advice available: Confidential Personal Questionnaire: Uncover, recover, discover your own personal secret in writing, perhaps, to one you trust, riting with your companions in the way, writhing for joy, righting your mistakes and wrighting all you can to create a new world NOW...
YOUR OWN PERSONAL, PRIVATE & CONFIDENTIAL QUESTIONNAIRE:
This is only one of several self-help aids included within this family of websites. Also available: Set of 22 vital questions. Suggestions for keeping a Personal Journal. Twelve-steps to planned Career Change. Identifying and overcoming blocks to Creativity.
Answers may, if you wish, be posted to -
Creativity House, 9 Oxford Street, St. Thomas, EXETER, Devon EX2 9AG, U.K.
marked for the attention of His Benevolence The Extra-Reverend The Preliminary LibrArian emeritus I+N The Neith Network, Doctor Colin James Hamer ( Shivananda ).
NAME IN FULL -
HOME eMAIL ADDRESS &/OR FAX &/OR TELEPHONE NUMBER -
e-MAIL ADDRESS &/OR FAX &/OR TELEPHONE NUMBER AT WORK -
PRESENT ADDRESS IN FULL -
DATE AND, IF POSSIBLE, PLACE & TIME OF BIRTH -
NAME AT BIRTH, IF DIFFERENT FROM THAT GIVEN ABOVE -
(1) Which women and men, living or dead, do you most appreciate and admire? Why?
(2) Which are your favourite books, and which have you found most helpful? In what ways?
(3) Which films have you liked most? Why?
(4) Which are your preferred radio and television programmes? Why?
(5) What do you find most congenial to you about any computers you use? Why?
(6) Which poems and songs are now your favourites? Why?
(7) Do you prefer paintings or statues? Which of these do you most admire? Why?
(8) Name your favourite plays. What do you like about them?
(9) Which games and sports, if any, do you enjoy playing? Do you also enjoy, or prefer being a spectator? If so, in which ways?
(10) What is your attitude towards time? Is is too long or too short? Explain.
(11) How easily do you allow other persons to enter, to rearrange or even to control your space? Explain your answer.
(12) What is your attitude towards money? wealth? poverty?
(13) Is morality important to you? In what ways?
(14) Are you an individualist, or do you feel family, society, country and a united world are important values? Explain your answer.
(15) What does friendship mean to you?
(16) What is your attitude towards love? What do you mean by it? What do you think of the opposite sex? your own sex? marriage? children?
(17) What causes you most pain and suffering? Was your childhood happy or sad? What troubles you most now?
(18) What brings you most joy and happiness? How do you feel about being always happy? Do you believe such a state is possible for you? If so, how might it be achieved?
(19) What significance, value and purpose does life have for you?
(20) Are you an optimist or a pessimist? Explain.
(21) What is your attitude towards religion? Explain.
(22) What caused you to occupy your time at present with the particular work, study or other pursuits that you are currently engaged in? Is this significant?
(23) Do you prefer city life? the country? the seaside? In what ways?
(24) In your inner life, which aspects are most important - thinking? imagination? feeling? prayer? meditation? dreams? special vibrations?
(25) How did your time at school influence your present life?
(26) What is your attitude towards the present world economic, political and social situation?
(27) How do you rate yourself for: General conduct? Spitefulness? Personal appearance and hygeine? Changeability of mood? Sense of discipline? Temper? Sense of humour? Being moved to tears? Personality? Stability? Application to work? Troublesome behaviour? Alertness? Defiance? Concentration? Destructiveness? Perseverance? Cooperation? Energy? Anxiety to please? Quality of social relationships? Attention seeking? Number and variety of friends? Deceitfulness? Bullying? Lying? Submissiveness? Hobbies and pastimes? Domineering others? Sports and games? Aggression? Love life? Timidity? Originality and creativity? Nervousness? Anxiety? Day-dreaming? Excitability? Impulsiveness? Boasting? Leadership? Self-reliance? Dependence on others? Selfishness? Attraction towards persons of various ages?
(28) How, in particular, do you rate your non-verbal and conversational social skills? Is your speech too loud, too soft, audible, clear? Is your tone of voice dull, monotonous, pleasantly varied? Is your facial expression lively and versatile? Do you make the right amount of eye-contact with others? Is your posture rigid, slouched, comfortable, relaxed? Do you show interest in other people enough? too much? Do you talk interestingly about yourself? Too much? Too little? Do you ask questions to open up the conversation more? Do you pick up on and reflect others' ideas, or ignore them? When others ask questions - do you say 'yes' or 'no'? or do you ignore them altogether? or do you elaborate on them?
(29) PRESENT COMPLAINT?
(30) Previous occasions of the same complaint?
(31) Previous illnesses of any sort?
(32) Your family history -
Mother? Alive or dead? If dead, when and how? How did you get on with her? (How do you?) Did she have special favourites? Have you always told her everything? If not, how reserved were you? (Are you?) Could you criticise her openly? Did she (does she) have moods? Or always cheerful? House-proud? Or rather messy? Affectionate? Smothering? Unfeeling? Self-centred? What did mother want you to be, or do? How much freedom had you as a child to play out and entertain? Was she on good terms with the neighbours? Did you ever feel ashamed of anything she was, or did? With what emotions do you think of your mother now? What was her attitude to your school-work, games, friends, etc?
Father? Personality? How did he earn his living? What was his attitude to work? To recreation? Did he take an interest in you? In other children? Were you punished at home? If so, how? Did your parents love each other? Did they love you?
Brothers and sisters? Names and ages? Present marital status? Occupations? General and mental health or illness of each? Your relationships with them?
Other important personal influences? Grandparents? Aunts and uncles? Teachers and clergy? Others?
(33) Previous personal history -
Early days? Influences on mother during pregnancy? Mother's labour before your birth? Traumas? Breast-feeding? A happy baby? Or always screaming? Sleeping difficulties or illnesses? What did mother do, if you cried? Comments about sitting, walking, teething, feeding yourself, bowel and bladder training? Were you an early or a late developer?
Childhood disturbances? Night terrors? Sleep-walking? Temper tantrums? Bed-wetting? Thumb-sucking? Nail-biting? Breath-holding? Food fads? Abnormal bowel habits? Stammering? Tics and mannerisms? Phobias or irrational fears?
General health during childhood? Any severe infections, illnesses, fits, allergies - such as dermatitis, hay-fever or asthma? Any recurrent illnesses or operations? Any periods in hospital and away from mother? Effects of this?
School? Regular attendance? Off sick? Truancy? Any special happiness and success? Any particular frustrations and failures? Relationships? Occupations? Progress?
Work? How and when did you choose your first job? What did you feel about starting work? What is your attitude towards authority, equals, those under you? How do you react to criticism? Have you a career structure? Do you enjoy your work? Any crises?
Puberty and adolescence? Feelings about the changes in your body? Masturbation anxieties? Relationships with others of your own age? Had you somebody to turn to?
Sexual and marital history?
Children?
Habits and routines?
(34) NAME, ADDRESS AND PHONE NUMBER OF YOUR PRESENT DOCTOR?
(35) Biorhythmic status on 7th February 2000:
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(36) Status of Principal Chakras, if known, on two separate occasions (please also specify time, place, circumstances):
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Left Sole: |
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Right Knee: |
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Base of Spine: |
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Spleen: |
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Solar Plexus: |
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Heart: |
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Throat: |
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Left Elbow: |
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Right Palm: |
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Brow: |
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Crown: |
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Star of David: |
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(37) Additional Observations?
(38) Personal Signature:
(39) Date of completion of this Questionnaire?
(40) Please provide recent photograph(s) if available -
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Webmaster: H.B. ExtraReverendDoctorColinJames Hamer, The Rainbow Programme
Creativity House, 9 Oxford Street, St. Thomas, EXETER, Devon EX2 9AG, U.K.