Community Profile
Welcome to our Community Profile Survey
Please take a few minutes to complete all questions as your opinion matters.
Please know that your personal information is for demographic analysis only and will not be shared with any third party or posted on the Internet.
We need your feedback to present statistics to the public, elected officials, and the media, that reveals the effects of the inhumane targeting of citizens througout this nation and the globe.
After completing this survey, you will be redirected to the Survey Methods website.
Thank you,
FFCHS Staff
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1.
Please enter your contact information
First Name
Last Name
Address
Address
City
US State
Please Select
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Zip Code
Home Phone
Cell Phone
Email Address
2.
Country or Region of the World
Please Select
United States
Africa
Asia
Australia
Canada
Caribbean
Europe
Latin America
Middle East
3.
Year of Birth
Please Select
1900-1909
1910-1919
1920-1929
1930-1939
1940-1949
1950-1959
1960-1969
1970-1979
1980-1989
1990-1999
2000-2008
4.
Gender
Please Select
Male
Female
5.
Marital Status
Single - never married
Single - divorced
Separated
Married
6.
What is your race or ethnic background? The answer to this question may be important in determining target selection.
African
Caucasian
Asian
If other, please specify
7.
What is your religious affiliation?
Catholic
Protestant
Non-denominational
Jewish
Muslim
If other, please specify
8.
Highest Education Level
Please Select
GED
K-12
College Graduate
Master's Degree
Doctorate
9.
Are you employed?
Yes
No
10.
If yes, what type of job do you have?
Please Select
Profession
Trade
Unskilled labor
11.
Do you have a website?
Yes
No
12.
If so, what's the url? Or leave blank.
13.
Do you have a blog?
Yes
No
14.
If so, what's the url? Or leave blank.
15.
Where did your targeting start?
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Navada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
16.
When did your targeting start?
Please Select
1950 or Earlier
1951 - 1955
1956 - 1960
1961 - 1965
1966 - 1970
1971 - 1975
1976 - 1980
1981 - 1985
1986 - 1990
1991 - 1995
1996 - 2000
2001 - 2005
2005 - Present
17.
If outside the US, in what country or region did your targeting begin?
United States
Africa
Asia
Australia
Canada
Europe
Latin America
Middle East
18.
Who do you believe is targeting you? You may select one or more responses
NSA
CIA
FBI
Secret Service
A Military Intelligence Agency
Not Sure
If other, please specify
19.
Are you an organized stalking victim?
Yes
No
20.
Are you a Directed Energy Weapons victim?
Yes
No
21.
Has your physician been of any support or assistance to you in treating your medical condition(s) due to the directed energy assaults?
Yes
No
N/A
22.
Have you reported your harassment to your local police?
Yes
No
23.
If yes, what was their response? You may select one or more responses.
Interested, will look into the matter
Listened, but took no further action
Referred to other department or agency
Uninterested, no action taken
Recommended psychiatric evaluation
Hostile
24.
Have you reported your harassment to the FBI?
Yes
No
25.
If yes, what was their response? You may select one or more responses.
Interested, will look into the matter
Listened, but took no further action
Referred to other department or agency
Uninterested, no action taken
Recommended psychiatric evaluation
Hostile
26.
Have you sought assistance regarding your harassment from your state or congressional officials?
Yes
No
27.
If yes, what was their response? You may select one or more responses.
Interested, will look into the matter
Listened, but took no further action
Referred to other department or agency
Uninterested, no action taken
Recommended psychiatric evaluation
Hostile
28.
When your targeting began, did you live near a military base?
Yes
No
29.
When your targeting began, did you live near a defense contractor(s)?
Yes
No
Not Sure
30.
When your targeting began, did you live near a weapons manufacturer(s)?
Yes
No
Not Sure
31.
When your targeting began, did you live near a US intelligence agency?
Yes
No
Not Sure
32.
When your targeting began, did you live near a major university(ies)?
Yes
No
33.
When your targeting began, did you live near a major hospital?
Yes
No
34.
When your targeting began, did you live near a biomedical research facility?
Yes
No
Not Sure
35.
When your targeting began, did you live near a public or private psychiatric facility?
Yes
No
Not Sure
36.
Organized Stalking Activities. Please check all that apply.
Appliance Tampering
Helicopter/Airplane home flyovers
Being Followed
Blacklisting
Car Tampering
Home Monitoring
Community-based Harassment
Workplace Harassment Activity
Mail Tampering
Computer Tampering
Noise Campaigns
E-mail Monitoring/Interference
Street Theater
Emergency Vehicle Harassment (police, fire trucks,. ambulances)
Targeting of Pets
Unexplained Sounds in Home
Estrangement of Family or Friends
Wiretapping/Electronic Surveillance
Food Tampering
If other, please specify
I have no proof of these
37.
Directed Energy Weapons Assaults. Please check all that apply.
Benign or Malignant Tumors
Induced Imagery/Thoughts
Ringing in Ears
Body Manipulation
Holograms
Induced Sleep
Seizures
Chilling of Skin/ Instant Coldness - Generalized or Localized
Thermal heating, daytime, discernible "microwave hot spots" on skull
Thermal heating, nighttime, severe night sweats
Induced Smells
Sensation of Blunt Trauma to Head
Coughing up Blood
Intense Itching
Sensation of Electric Current Running through the Body
Dehydration
Sudden onset asthma
Irregular Heartbeat
Hyperactive bladder, sudden incontinence
Sensation of Objects being Forced into various areas of the Body
Deterioration of Cognitive Abilities
Jaw or Tooth Pain
Severe facial and glandular swelling.
Sleep Deprivation
Dizziness or Loss of Balance
Blackouts or loss of consciousness
Severe disorientation while driving
Lesions on Internal Organs
Sudden Rashes
Sudden appearance of large burn marks
Dream Manipulation
Memory Loss
Thought Monitoring/Manipulation
Electronic Rape
Metallic Taste in Mouth
Thyroid Problems
Electroshocks
Nausea
Tingling
Extreme Fatigue
Nosebleeds
Topical & Internal Burning
Genital Manipulation
Numbness
Vision Loss/Impairment
Hair Loss
If other, please specify
pinpoint rhythmic pains. Few minutes each. vocal cord region, neck, head in several areas. numb painful calves & feet once, sour stomach, racing thoughts, right 4th finger bending involuntary (at 1st). dream hallucinations? (with voices. tinnitis), foot vibration, very slight involuntary head shaking & nodding (yes & no) & while while I have thoughts (as if they are cummuncating with me). anxiety. head wooziness. Head electric shock 2times. Left skull, skin stiffness (including the left orbit), for months. Noticed when raising eyebrows. Other symptoms I can't remember now.