Vision During Experience, and Healing Ability After

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Vision During, and Healing Ability After Experience.

    You are being contacted because you previously shared your experience with us at the Near Death Experience Research Foundation (NDERF, www.nderf.org) or Out of Body Experience Research Foundation, www.oberf.org).  In s
haring your experience, you indicated approval to be contacted by a NDERF approved researcher, and approval to be contacted via e-mail.  You may be assured we have and will continue to keep your contribution and your contact information confidential to the extent you desire.

    For those of you who have not shared your experience with us but who wish to participate in the survey, please give us a description of what happened to you so that we can properly classify your experience and include it in the survey results.

    This confidential survey should take less than ten minutes to complete. For those completing the survey who are interested, we will send you a summary of the results of this survey when complete (a check box for this is at the end of the survey).

    The purpose of this investigation is to study vision during the out of body part of the experience, at a time when earthly, every day events may be seen.  This investigation will also study possible healing ability after the experience.  We recognize many experiences do not involve visualizing earthly, every day events, and healing ability afterwards.  It is important that you complete this survey even if you did not visualize earthly, every day events during your experience, or do not believe you experienced healing ability after the experience.

    Participation in this survey is voluntary.  There is no compensation for participation in this study.  All survey information shared, including e-mail addresses, will be maintained in strict confidence and will not be released to any third party without explicit prior authorization of the respondent.  Analysis of the results of this survey may be published without identifying any respondent individually.  It is anticipated that the results of this survey will be presented at the IANDS (International Association for Near-Death Studies) annual conference in January, 2003.

    If you had more than one experience, please complete the survey with regard to only one experience which involved visualization of every day, earthly events during the experience. 

    If you are unable to send the form results electronically, please print the form, write your responses on the form as appropriate, and mail or fax the form to:

            Fax:
  
          (253) 568-7778
           
            Postal Address:
    
        NDERF
            P.O. Box
23367
            Federal Way
, Washington
98093

    Submission of your responses will constitute informed consent to participate in this study.  Please submit your responses only once.

1.    Please fill out the form below as completely and accurately as you can.  Your contribution, including your e-mail address, will remain confidential.

2.   
Please do not forget to press the "Submit" button at the end, or the information will be lost! 

3.    After you press the "Submit" button, a review of your responses will be shown, and the information will have been sent.  A button will allow you to return to this page.  The form may or may not have your responses in the boxes, but all information will have been sent.  If you have any questions or concerns please E-mail me
Below you will find further information regarding this study's co-investigators.

4.    Text that you enter in the following boxes will scroll automatically if needed, allowing you to enter as long a response to each question as you want.

Thank you so much for your participation in our study!
 

IMPORTANT: The following questions pertain only to the early part of your experience when you were able to see earthly, every day events occurring at that time, such as seeing your own body, other people or other things.  In answering these questions, please do not consider what you saw or how you saw things, during any other part of your experience. 

Note: we must have at least one of: 1) your experience registry number, 2) e-mail address, or 3) name, to correlate your response to this survey with your experience previously shared with us.

Please indicate your experience registry number included in our e-mail to you (if you are not sure of the registry number, please skip to the next question):

 

Your name (first and last please), e-mail address, and your mailing address if it has changed:


IF YOU HAVE NOT SUBMITTED YOUR EXPERIENCE TO THE (NDERF www.nderf.org or OBERF www.oberf.org) WEBSITE AND WISH TO PARTICIPATE IN THE SURVEY, Please describe your experience using as much detail as you can so we know how to classify it for the survey results.  Use as much space as you need (scroll bars allow unlimited amount of writing):  If you have submitted your experience, then skip this question.


Did your experience involve seeing earthly, every day events?

Yes        Uncertain        No        No response
(
You may change your answer at any time by clicking a different button for questions with buttons)


If your experience did not involve seeing of every day, earthly events, please
Click Here


1.  DESCRIPTION OF WHAT WAS SEEN IN THE EARLY PART OF THE EXPERIENCE INVOLVING EARTHLY, EVERY DAY EVENTS (such as seeing your body, or other people, or other things, etc.):



2.  HOW LONG DID THIS PART OF THE EXPERIENCE LAST (best time estimate you have, such as seconds-minutes-hours in earthly time):



3.  POINT OF VISUAL REFERENCE - Please describe as accurately and comprehensively as possible where your point of vision was located relative to your body, including direction and distance from your body, and any change over time in your point of visual reference:


4.
  Did your vision during the early part of your experience when you were observing earthly events differ in any way from your normal, everyday vision
(in any aspect, such as motion, degree of solidness/transparency of objects, vision change during experience, etc.)?

Yes        Uncertain        No        No response

If Yes or Uncertain, please explain:




5.  CLARITY -
How clearly (clarity) did you see?  Select the best answer on a scale of 1 to 6, with 1 being no clarity and 6 being normal clarity:

                                                                   
        1               2               3                  4               5               6    (No response)
  NO Clarity                                                                 NORMAL Clarity
        
If there was any impairment in clarity, please explain: 



If the clarity was unlike earthly, every day vision, please explain: 




6.  UNIFORMITY OF VISUAL FIELD - How was the uniformity field of vision with regard to clarity, color and distortionSelect the best answer on a scale of 1 to 6 with 1 being completely non-uniform, and 6 being completely uniform. 

                
                                                           
       
1               2               3                  4               5               6                (No response)
COMPLETELY                                                             COMPLETELY
NON-UNIFORM                                                                 UNIFORM



If there was any impairment in uniformity of visual field, please explain: 




If the uniformity of the visual field was unlike earthly, every day existence, please explain: 




7.  Distortion - Was there any distortion in what you saw?  Select the best answer on a scale of 1 to 6 with 1 being total distortion and 6 being no distortion:

                                                                  
        1               2               3                  4               5               6   (No response)
TOTAL Distortion                                                          NO Distortion
        
If there was any distortion in what you saw, please explain: 



8.  Color -
Could you see color?  Select the best answer on a scale of 1 to 6, with 1 being no color and 6 being normal color vision:

                                                                     
        1               2               3                  4               5               6       (No response)
  NO Color                                                           NORMAL Color Vision
        
If there was any impairment in seeing color, please explain: 


 

If any color was unlike earthly, every day existence, please explain: 


9.  FIELD OF VISION - How wide was your field of vision?  Field of vision may range from very limited "tunnel" vision to normal full width of field of vision or wider than normal field of vision.  Select the best answer on a scale of 1 to 6, with 1 being virtually no field of vision and 6 being able to see total normal or wider field of vision:

                                                                   
        1               2               3                  4               5               6       (No response)
  Virtually NO                                                                   NORMAL
Field of Vision                                                           Field of Vision

        
If there was any impairment in your field of vision, please explain: 




If the field of vision was unlike earthly, every day existence, please explain: 

 
10.  LIGHTNESS/DARKNESS -
Was there any unusual lightness or darkness in what you saw?  Select the best answer on a scale of 1 to 6 with 1 being total unusual light or darkness, and 6 being normal light and darkness:

                
                                                    
       
1               2               3                  4               5               6        (No response)
Total UNUSUAL                                                        Total NORMAL
Light or Darkness                                                Light and Darkness

        
If there was any unusual lightness or darkness, please explain: 



11.  DEPTH PERCEPTION - How accurately did you perceive depth?  Select the best answer on a scale of 1 to 6, with 1 being no depth perception and 6 normal depth perception:

                
                                                  
       
1               2               3                  4               5               6        (No response)
   NO Depth                                                                NORMAL Depth
 Perception                                                                    Perception

    

If there was any impairment in depth perception, please explain: 




If the depth perception was unlike earthly, every day existence, please explain: 




12.  YOUR EARTHLY, EVERYDAY VISION (without correction by glasses or contact lens)
Describe your uncorrected earthly, everyday vision at the time of your experience.  Select the best answer on a scale of 1 to 6 with 1 being completely without vision, and 6 normal uncorrected vision (without glasses or contact lens):

                                                                       
        1               2               3                  4               5               6         (No response)
  Completely                                                                       Normal
Without Vision                                                                    Vision

    

If there was any impairment in your earthly vision, please explain: 




13.  YOUR ABILITY TO READ (alphabet and numbers) - During the initial part of your experience involving visualization of earthly, every day events, if letters, words or numbers had been optimally placed for you to see during the experience, would you have been able to see & recall alphabet and numbers?  Select the best answer on a scale of 1 to 6, with 1 being definitely not able to see and recall, and 6 being definitely would be able to see and recall:

                                                                       
        1               2               3                  4               5               6             (No response)
  NO-Would                                                                     YES-Would
Not See & Recall                                               Completely See & Recall

    

If there would have been any impairment in your ability to read and recall alphabet and numbers, please explain: 



Do you have a possible explanation for your ability to see earthly, every day events during the initial part of your experience?


Did you actually read/recognize anything such as alphabet, numbers, or symbols during your experience?
 

If yes to above, do you recall where the writing was in relationship to your  physical body? 

Do you have any suggestions as to what type of information you might have noticed or remembered while out of your body and where in relationship to your physical body you might have the greatest chance of noticing it?

14.  Multiple Experiences.  Have you had an out of body experience (OBE) separate and distinct from the OBE you have submitted to the website? 

Yes        Uncertain        No        No response

If Yes or Uncertain, was the visual component the same or was it different when comparing the two or more experiences?  If it was different, could you describe how the visual component was different?


IMPORTANT
:
The following questions pertain to any potential relationship between experience and your possible healing ability after the experience. 


15.
  What does healing mean to you?



16.  Did you have any healing ability (your ability to heal others)
before your experience? 
Yes        Uncertain        No        No response
If Yes or Uncertain, please explain (such as what your healing abilities were, and how did you use them
before your experience):

 
17. 
Did you have healing abilities (your ability to heal others) after your experience?
Yes        Uncertain        No        No response


Have you experienced any change in your ability to heal others after your experience?

Yes        Uncertain        No        No response

If Yes or Uncertain, please explain (such as what your healing abilities were before, how they changed, and how you used them after your experience)


18.  Have you used your healing abilities to heal another person? 
Yes        Uncertain        No        No response
If Yes or Uncertain, please describe in detail one or several of the most evidential (i.e. convincing to others) healing(s) that you performed, including how you healed, and what the results were? 


If "No" to above, please go to question 19

If "Yes" to above, could this healing have been contributed to by something other than your healing abilities (such as ongoing treatment by a doctor, etc.)?


If "Yes" to question 18, is there any medical evidence like a medical chart that would substantiate your healing ability? 
Yes        Uncertain        No        No response


19
.  Have you ever you experienced any physical healing that you attribute to your experience?
Yes        Uncertain        No        No response
If Yes or Uncertain, please explain:


20.  After your experience did you become more sensitive to medications? 
Yes        Uncertain        No        No response
If Yes or Uncertain, please explain:



21.  Have you ever you experienced any emotional healing that you attribute to your experience? 
Yes        Uncertain        No        No response
If Yes or Uncertain, please explain:



22.  Did the questions asked and information you provided accurately and comprehensively describe all aspects of your vision during the early part of your experience when you were observing earthly, every day events, and regarding your possible healing abilities?
Yes        Uncertain        No        No response
If No or Uncertain, please explain:




23.  If you would like to be informed of the results of this study, please indicate which e-mail address you would like us to send the results.  Please allow several months for results of this study to be available.


   Thanks!!!

PLEASE REMEMBER to PRESS Submit BUTTON!

 
Thank you so much for your participation in our study!  
 

  Caution... Reset button will "FLUSH" all data submitted!


 
Last revised: February 03, 2013


Study Investigators:

Dr. Jeff & Jody Long

 

Copyright1999 by Dr. Jeff and Jody Long


e-mail:   Webmaster:  Jody A. Long


 

 

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