Name:
Birthplace:
Birthdate:
Family
Do both parents live with you?
Siblings:
Aunts and Uncles:
Cousins:
Are all your grandparents alive?
Home
Do you consider your house a broken home?
Do you get yelled at too often?
Have you ever been kicked out?
Have you ever ran away?
Do you tell your friends about your house?
Your Past
What was the first thing you remember wanting to be when you grew up?
What was your first pets name?
Who was your first best friend?
When did you loose your first tooth?
Have you ever made the honor roll in school?
Have you ever been to a funeral?
Can you remember your first nightmare? What was it?
Have you ever sleep walked?
Have you ever smoked cigarettes or anything else?
Have you ever drank alcohol? [before you were 21?]
What is your scariest memory?
What is your best memory?
Where is your favorite vacation spot that you have been to?
What was your favorite color when you were growing up?
Did you ever have stiches?
Did you ever get in a fight?
Did you ever get suspended from school?
Did you/do you ride the school bus?
Who was your favorite singer/group as a child?
As of today, how many concerts have you been to?
What was your favorite tv show as a child?
What is your favorite Disney movie?
What do you wish you could change about your past?
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