New England Supernatural Support

Confidential Initial Request Questionnaire

Please answer all questions

* 1. Your first and last name

* 2. Best contact phone number

* 3. Do you own the property in question?

* 4. Please list the address of the property. If this is a business please list the name of the business also.

* 5. Are you over 18 years of age?

* 6. If residential: Please list any occupants of the home and their ages.
If a business: Please give a general idea of the number of employees and general ages.

* 7. Please briefly describe your situation, such as experiences and occurrences that have caused concern.

* 8. What is your preferred email address?

* 9. In the event we can not reach you, is there someone else we should contact as well?
List name, phone, and/or email address

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