Please answer all questions to the best of your ability. Do not waste our time with vague responses!

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This form will help establish information that will help us connect Targeted Individuals in the most efficient way. We require your email to prevent malicious submissions.

Remember... This is not a support-group.

Email *

Please enter your Discord or Reddit username, so we can match these results with your user-account.

Did you work for a company that is/was protected under The Department of Homeland Security? (Ex; Chemical storage, Trucking company that transported hazardous or explosive materials, A company that accepted military contracts)
*

Yes

Unknown

Did you live near a military base or a company that was protected under The Department of Homeland Security?
*

Yes

Unknown

If you answered "YES" to either of the above questions, please provide additional information.

Commonalities with other Targeted Individuals. *

I was around someone who participated in illegal activities.

I was friends with (or associated with) Gang members, Biker Club members, or Cults.

I engaged in human trafficking. [Prostitution]

I expressed suicidal or homicidal ideation. [Threatened to kill yourself, or someone else]

I used the Deep Web and/or Crypto-Currency.

I folded into a poor state of mental health while isolating.

I experienced childhood trauma, that effected my adult life.

I used technology [Phone, PC] in a way that could implicate myself. [Ex; Purchase illicit substances.]

I watch or have watched Porn on a regular basis.

I initiated an IPO/EPO [Protective Order] on another individual.

I was served with an IPO/EPO [Protective Order], filed by another individual.

I have been involved in Domestic Violence situations, where police were called.

Other:

Required

Summarize Your Religious and/or Spiritual Beliefs

How loud is the V2K for you? *

I don't hear "V2K"

Perfectly Understandable Dialog

What are you experiencing? *

Some TIs experience a specific set of side-effects. Check all that apply.

High Pitched Tinnitus [Ringing Ears]

Feeling of Being Watched or Observed.

Physical Sensations. [Pricks, Pokes, Vibrating Extremities, Shocking Sensations, Synthetic Pain]

Sleep Deprivation. [Coughs, Knocks, Door-Slamming, People Yelling, Zaps]

Voice2Skull [V2K] - Someone talking inside your head.

I hear someone shouting my name.

Other:

Required

Voice2Skull [V2K] Additional Questions

Many Targeted Individuals hear one or more "voices" that can't seem to be captured with audio equipment or regular microphones, and seems to emanate from within the skull.

I hear distant chatter, like a group of people playing cards around a table.

I hear one or more voices clearly enough to have a conversation.

I hear screaming or yelling, sometimes accompanied by shock or excitement.

I hear Music playing.

I talk, argue, or debate with my V2K.

The V2K threatens my life.

The V2K says derogatory or offensive things about my character.

Other:

Some TIs who can hear the V2K clearly, are often told the same repeated phrases. Check all options that apply to your experience...

... All the time...

"... That's all I'm trying to do..." or "... That's all I'm trying to show you..."

This is happening, because ....

I'm trying to help you ...

You were ... all the time, and that's why I'm doing this!

Don't talk to the voices inside your head!

Do what you're supposed to do!

You have to do something with your life!

You don't know what this means for your life.

Other:

Are You Being Assaulted With DEW Attacks? *

Nope

Severe Pain

If You Are Being Assaulted With Directed Energy Weapons. Check the felt sensations... *

I feel vibrating extremities. (Ex; Feet, Hands, Fingers or Other Areas)

Burning or Heat Sensations

Cold Sensations

Pin Pricks

General Pain

Static Sensations or Shocking

I don't believe I'm being hit with DEWs

Bloating

Itching

Other:

Required

If You Are Being Assaulted With Directed Energy Weapons. Check the affected areas of the body... *

Head

Temples

Ears

Nose

Face

Genitals

Rectum

Arms

Legs

Hands and/or Fingers

Feet and/or Toes

Back

None. I am not being hit with DEWs.

Other:

Required

How likely are you to participate in Resistance Events? *

I'm too afraid.

I'm done being afraid.

Are you financially stable enough (and willing) to travel to Central/Eastern USA for physical meetings? *

Have you purchased any equipment to aid in detection and defense strategies? (Ex; Spectrum Analyzers, Jammers, Shielding Materials) *

Yes

If You Answered Yes To The Above Question, Please Specify The Equipment That You Have Purchased...

In the last 12-months [1-Year], how much have you isolated? *

Never

Always

Do you enjoy the company of like-minded people? *

Nope!

Love it!

Are you armed? Do you own a defensive weapon?

Yes

Maybe

Clear selection

What is your approximate location? (City and State or Only State Ex; Louisville, KY)

Use the below input to describe your experience. When did it start? Why do you think this is happening? Tell us what you've learned!

Send me a copy of my responses.

Submit

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