The list below includes items that you may or may not experience.  Please consider how often you directly had this experience before your near-death experience, and how often you directly have this experience since your NDE.  Try to disregard whether you feel your should or should not have these experiences.  Some of these items used the word “God.”  If that word is not comfortable for you, please substitute another idea that calls to mind the divine or holy for you.

1.  I feel God’s presence.

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: Before July 25 2003
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day   
 
	Since your NDE: After July 25 2003 wheneer I look for devine presence
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

2.  I experience a connection to all life. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

3.  During worship, or at other times when connecting with God, I feel joy, which lifts me out of my daily concerns. 

	Before your NDE: Never went to Chruch
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: My higher power does not require worship
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

4.  I find strength in my religion or my spirituality. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: Spirituality
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

5.  I find comfort in my religion or my spirituality. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: Spirituality
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

6.  I feel deep inner peace or harmony. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

7.  I ask for God’s help in the midst of daily activities. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

8.  I feel guided by God in the midst of daily activities. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

9.  I feel God’s love for me, directly. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

10.  I feel God’s love for me, through others. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

11.  I am spiritually touched by the beauty of creation. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

12.  I feel thankful for my blessings. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

13.  I feel a selfless caring for others. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

14.  I accept others even when they do things that I think are wrong. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

15.  I desire to be closer to God or in union with the divine. 

	Before your NDE:
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day    

	Since your NDE: 
                        1---------------2---------------3---------------4---------------5---------------6
           almost never    once in a while   some days    most days     every day     many times a day     

16.  In general, how close do you feel to God?

	Before your NDE:
                                       1--------------------2--------------------3--------------------4
                            not close at all     somewhat close       very close      as close as possible

	Since your NDE: 
                                       1--------------------2--------------------3--------------------4
                            not close at all     somewhat close       very close      as close as possible

Whether or not you are spiritual or religious, please indicate the extent to which these statements are true for you since your near-death experience.  Think about how you were before your NDE and how you are now.  Mark the number below each statement that best describes any changes that have occurred.

1.  Spirituality has become more important to me.

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

2.  My way of looking at life has changed to be more spiritual. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

3.  Because of spiritual changes I’ve been through, I’ve changed my priorities. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

4.  I pay more attention to things that are spiritually important and forget about the little things that used to bother me. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

5.  I pray or meditate more often. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

6.  I spend more time taking care of my spiritual needs. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

7.   I more often experience life around me as spiritual. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

8.  I more often see my own life as sacred. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

9.  I have a stronger spiritual connection to other people. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

10.  I have a stronger spiritual connection to nature. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

11.  Spiritually I am like a new person. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

12.  Taking care of my body has taken on spiritual meaning. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

13.  My relationships with others have taken on more spiritual meaning. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

14.  I have a stronger sense of the Sacred (God, Higher Power, Allah, etc.) directing my life now. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal
15.  I act more compassionately towards other people since my NDE. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

16.  I see people in a more positive light. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

17.  I more often express my spirituality. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

18.  I spend more time thinking about spiritual questions. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

19.  I am more humble since my NDE. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

20.  I more often think about how blessed I am. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

21.  I have grown spiritually. Took 26 years

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal
 
22.  I am more spiritually present in the moment. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

23.  I take part in spiritual rituals more often. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

24.  I more often have a sense of gratitude. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal
25.  I more often pray for other people. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

26.  My spirituality is now more deeply imbedded in my whole being. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

27.  I am more receptive to spiritual care from others (such as prayer or healing practices). 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

28.  I more often look for a spiritual purpose in my life. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

29.  I’m finding it more important to participate in a spiritual community. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

30.  In some ways, I’m spiritually withdrawn from other people. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

31.  My faith has been shaken and I am not sure what I believe. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

32.  Spirituality seems less important to me now. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal
 
33.  In some ways, I have shut down spiritually. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

34.  In some ways, I think I am spiritually lost. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal
35.  I feel I’ve lost some important spiritual meaning that I had before. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

36.  My relationships with other people have lost some spiritual meaning. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

37.  I am more spiritually wounded. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

38.  In some ways, I am off my spiritual path. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

39.  I more often think that I have failed in my faith. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

40.  I am less interested in organized religion. 

                    1-------------2-------------3-------------4-------------5-------------6-------------7
          not at all true                                                                                             true a great deal

903