Exploring Consciousness Beyond Physical Life
1. Have you ever had what you consider to be a Near-Death Experience (NDE)?*
2. Have you had more than one NDE?*
3. If you selected "Yes" to Question 2 above - please enter the number of NDE's you have had?*
Please Note: If you have only had the one NDE incident, then simply enter the number 1.
For all of the following questions, please refer to the main NDE incident for the remainder of the survey. You may if you wish, complete the questionnaire for each of your other NDE's.
4. What was the cause that led to your NDE?*
5. During the NDE did you perceive yourself to be dying, on a path towards death or actually dead? (please complete each column of questions)*
6. In retrospect, how close did you come to actual death?*
7. How old (in years) were you at the time of your NDE?*
8. How old (in years) are you now?*
9. In relation to the NDE, did time seem to speed up?*
10. In relation to the NDE, were your thoughts speeded up?*
11. In relation to the NDE, did scenes from your past come back to you?*
12. In relation to the NDE, did you suddenly seem to understand everything?*
13. In relation to the NDE, did you have a feeling of peace or pleasantness?
14. In relation to the NDE, did you have a feeling of joy?
15. In relation to the NDE, did you feel a sense of harmony or unity with the universe?
16. In relation to the NDE, did you see or feel surrounded by a brilliant light?
17. In relation to the NDE, were your senses more vivid than usual?*
18. In relation to the NDE, did you seem to be aware of things going on elsewhere, as if by extra sensory perception (ESP)?*
19. In relation to the NDE, did scenes from the future come to you?*
20. In relation to the NDE, did you feel separated from your physical body?*
21. In relation to the NDE, did you seem to enter some other, unearthly world?*
22. In relation to the NDE, did you seem to encounter a mystical being or presence?*
23. In relation to the NDE, did you see deceased spirits or religious figures?*
24. In relation to the NDE, did you come to a border or point of no return?*
25. In what way has the NDE changed the following areas of your life? *
26. During the NDE did you experience any of the following? (choose as many as necessary)*
27. If you saw spirit beings, which of the following would you identify them with? (choose as many as necessary)*
28. After the NDE, do you recall "coming back to life"?*
29. When recalling "coming back to life", which of the following emotions did you experience (choose as many as necessary)?*
30. Since your NDE, have you changed in the following ways? (choose as many as necessary)*
31. How spiritual (personal) and / or religious (church) were you before your NDE? (please complete each column of questions)*
32. How spiritual (personal) and / or religious (church) are you since your NDE? (please complete each column of questions)*
33. What was your religious denomination before your NDE?*
34. Did your NDE change the religious denomination you aligned with?*
35. What is your religious denomination since your NDE?*
36. If your religious denomination changed since your NDE, please explain the reason for that change as best you can?*
37. Before your NDE how strong was your belief in God or a supreme being?*
38. Since your NDE how strong is your belief in God or a supreme being?*
39. Before your NDE, did you believe there was a singular and identifiable path to God or a supreme being?*
40. Since your NDE, has your belief in a singular and identifiable path to God or a supreme being changed?*
41. Before your NDE, did you believe in an afterlife?*
42. Since your NDE, do you believe in an afterlife?*
43. Before your NDE, did you believe that some form of consciousness existed beyond physical death?*
44. After your NDE, do you believe that some form of consciousness exists beyond physical death?*
45. Before your NDE, what were your conceptions of death? (choose as many as necessary)*
46. Since your NDE, what are your conceptions of death? (choose as many as necessary)*
47. Before your NDE, did you have a "fear of death and dying"?*
48. Since your NDE, has your "fear of death and dying" changed?*
49. In what way has your "fear of death and dying" changed?*
50. Have you shared your NDE with other people - AND for those you told about your NDE, how did they respond to your NDE disclosure? (please provide a response for each line.)*
51. The people you have shared the NDE with, have their lives changed as a result of your NDE disclosure to them? (please provide a response for each line.)*
52. Thank you for completing the questionnaire*