Personal History Questions

Background Information
Full Name
Today’s Date
Date of Birth
Place of Birth
Nationality
Ethnicity
Adult Height
Right or Left Handed
Eye Color
Natural Hair Color
Blood Type
Wear Glasses?
Profession
Allergies
Current Address
How tall are you?
What color was your hair as a young child and then as an adult?
What color are your eyes?
Where have you lived as an adult? List the places and the years that you lived
there.
Why are you living where you are today?
Do you wish you lived somewhere else (If so, where would it be)?

My Life’s Timeline
Here are suggested items to include in your timeline.
Your Birth
High School
Graduation
Retirement Begins!
Started School
First Date
Group Involvements
Birth of Younger Siblings
Got Engaged!
Deaths of Loved Ones
Family Moves
Marriage Date
College Years
Changed Schools
Birth of Your Children
Your First Anything
Achievements Son/Daughter-in-Laws
Your Children’s Firsts:
Summer Vacations
Birth of Grandchildren - tooth, steps etc…
Job/Career Changes
Eventful Business Trips
Anniversaries/Memories

Age Year Event

0 I WAS BORN
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Early Childhood
My full name is
I was born in (place of birth)
On (date of birth)
To (parents’ names)

What number (birth order) were you amongst your siblings?

Were you ever told at what time you were born? (Ex. 10:00am…10:00pm?)
What hospital were you born at?
Do you know the name of the person who delivered you?
Who where the first visitors to come see you?
Any complications at birth?
Any interesting details about your mother getting to the hospital in time?
Where you named after anyone? If so, who?
Your length at birth?
Your weight at birth?
Did you have hair? If so, how much?
Had you been born the opposite sex, did your parents have a name chosen?
What were your parents doing for a living in your early years?
Which relatives were involved with your early years the most?
What did you worry about as a child?
What was your overall health like as a child?
Describe the home(s) that your family lived in.
Describe your neighborhood(s)?
Can you remember any childhood rhymes or songs you used to say or sing?
Are there any other vivid memories from this time in your life?

My Early School Years

I started school at the age of
In the year

Describe your elementary school. Name? Public? Private?

In what city or town did you attend grade school?
Who was your favorite grade school teacher? Why?
Was there a teacher that you didn’t like? Why?
What did you usually wear to school?
How did you get to school? How far was it?
What subjects did you like and which ones didn’t you like?
Who were your best friends? Tell what you can about them. Do you know where
they are today? If so, do you keep in touch?
Did your siblings attend the same school? How many grades above or below
them were you?
What stories can you tell about your brothers and sisters during this time?
Ever get sent to the principal’s office? What did you do to get sent there?
Are there any accomplishments that you were particularly proud of? Did you win
a contest? Get elected to student office?
Did you participate in sports during grade school whether in school or in a city
league?
What were your schools like?
How did you get to school?
What was your favorite subject in school and why?
What subject in school was always the easiest for you?
What was your least favorite subject in school and why?
Who was your favorite teacher and why were they special?
How do your fellow classmates from school remember you best?
What school activities and sports did you participate in?
Did you and your friends have a special hang-out where you liked to spend time?
Where was it and what did you do there?
Were you ever given any special awards for your studies or school activities?
Did you like school?
What did you like the most and the least about it?
What did you usually wear to school? Describe it.
Did you find school easy or was it a struggle?
Who were your best friends?
Did you ever have to change schools?
List all of your school teachers in order! Tell a little bit about each.
What did they teach you? What did you like or dislike about them?
Did they expect you to live up to standards set by your older siblings?
First Grade Teacher
Second Grade Teacher
Third Grade Teacher
Fourth Grade Teacher
Fifth Grade Teacher
Sixth Grade Teacher

My Growing Up Years
What is your earliest memory as a child?
What is your happiest memory as a child?
What were you like as a child?
Was your upbringing a strict one?
What did you want to be when you grew up?
Who is the oldest person (relative) that you can remember?
Was there a chore you really hated doing as a child?
What kind of books did you like to read?
What did you do for fun as a child?
Describe your childhood home.
What were your favorite toys?
What childhood games did you play?
Who did you play them with?
What were some of the “old-fashioned” remedies for sickness that you remember
your parents using?
Do you remember any early childhood birthday parties? Describe what you
remember.
Tell about grandma’s house.
Did you ever get lost? Describe the feeling and circumstances.
Ever get stitches? What happened?
Where you ever hospitalized as a kid?
How did your family celebrate holidays?
What memories of mom’s kitchen do you have?
What were some of the TV shows you watched as a young child?
What family “get-togethers” do you remember from your early years?
Describe a nightmare that you still remember from your childhood?
Describe your first puppy love.
Tell about your first bike.
Do you remember your parents coming home from the hospital with a younger
brother and sister? Describe that memory.
Do you ever remember over hearing your parents discuss the name for a, as yet,
unborn sibling? Describe what you remember of that conversation.
Did you ever attend the funeral of a family member as a child?
Ever break something such as a window?
Ever physically fight with your brother(s) and/or sister(s)?
Describe your childhood bedroom.
What major news events do you remember, even vaguely, as a child?
How did your parents spend a typical day?
What are some of the characters that you dressed up as for Halloween?
Did your family attend church? What memories do you have of those places of
worship?
What family events stand out in your mind?
Did your family play cards and/or board games together? Which ones?
Did you have one babysitter more memorable than the others? Who was it and
why was he or she most memorable?
Do you still remember your first teddy bear or favorite stuffed animal?
In what ways are your siblings like either of your parents?
Which store’s wish book was your favorite?
Do you have any memories of world, state or county fairs?
Did you get paid an allowance? How much did you typically receive?
How did you earn spending money?
What were some of your parents’ greatest qualities?
What were some of your parents’ not-so-great qualities?
Did your parents emphasize achievement in school?
What was your role in the family?
Other than family, who were the most important people in your life when you were
growing up?
What were the happiest times of your childhood?
What were your biggest disappointments?
What were your hobbies as a kid?
When you were a kid, what did you imagine your adult life would be like?
What is your full name and why were you named it?
Were you named after somebody else?
Did you have a nickname as you were growing up?
If you did, what was it and why did they call you that?
Have you had other nicknames as an adult?
What do family members call you now?
Where were you born and when?
Who was the oldest person you can remember in your family as a child? What do
you remember about them?
Do you remember your family discussing world events and politics?
Was there a chore you really hated doing as a child?
What kinds of books did you like to read?
Do you ever remember not having enough food to eat because times were hard
for your family?
What were your favorite toys and what were they like?
What were your favorite childhood games?
Do you have a favorite story about a pet? What is it?

Teenage Years
What were you like as a teenager?
What’s the most outrageous thing you did as a teenager?
Were you involved with boy/girl scouting?
Which fads existed during your youth?
How old were you when you started dating?
Do you remember your first date? Describe it.
Tell about other memorable dates
What is the biggest purchase that you made in your youth with your own money?
What kind of part-time jobs did you have as a teenager?
What was the first book you ever read cover to cover? Tell about that book
What were some of the movies you went to see at the theatre?
Did you ever buy a car as a teenager?
Who were your heroes as a teenager?
Ever live in a foreign country? Tell about it
What were your hobbies as a teenager?
Tell about members of the opposite sex you couldn’t stop thinking about, but who
may not have even knew you existed? You know who I’m talking about!
Did you ever runaway from home?
Did you ever keep a diary or journal as a teen? If so, how are you preserving it?
Did you grow up in the country or the city?
Do you remember the family discussing world events and politics?
Was there a chore that you really hated?
What kind of book did/do you like to read?
How old where you when you first learned to drive a car?
How old where you when you first got your license to drive?
What kind of car was it that you learned to drive in?
Who taught you to drive?
When you first drove by yourself, where did you drive? Describe the feeling.
Did you take any class or special course to learn to drive? Describe your
experiences.
When you started driving on a regular basis, whose car did you drive mostly?
Ever get a traffic ticket? What was it for?
Did you have to go to traffic court? What was that like?
Ever involved in a car accident? What were the circumstances?
Ever go on a vacation with another (a friend’s) family?
Ever go to scout camp or any other type of camp during the summer?

High School Years

I began high school at the age of
And graduated in (year)

What was the name of your high school?

What was your school mascot?
Where is this high school located?
Overall, did you enjoy high school or did you hate it? Explain why?
Who did you have a crush on?
List some of the classes that you took in high school
Which classes did you do the best in?
Which ones did you feel lost in?
Did you consider yourself part of the “in” crowd?
List your favorite teachers.
Who were your friends?
Were you part of any clubs or organizations i.e. FFA, National Honor Society,
newspaper, drama club, annual staff etc…?
What were some of your biggest accomplishments in school?
Did you participate in any school sports?
Did you ever travel to a sport, band or other competition?
Describe yourself as a high school student (overall)
Did you have a boyfriend/girlfriend while in high school? Describe them.
Did you ever play practical jokes on anyone? What kind of things did you do?
Who did you play them on? Friends? Teachers?
Were you ever expelled from school?
What did you wear while in high school? Did you wear a uniform? What style of
clothing was in at the time?
What was the most embarrassing moment for you in high school?
What was the best moment for you in high school?
What type of music did you listen to? Who were the singers and music groups
you liked?
What was the standard music medium? 8 track, records, cassette tapes, CDs,
MP3?
Did you play in the school band? What instrument did you play? How good were
you and do you still play that instrument from time to time?
Ever attend a school dance? Ever take a date to one?
Did you ever get into a fight while at school?
What were your grades like in high school?
Did you ever fail a class? How did you feel about that? Was it just too hard or did
you just not put the effort into it? How did you parents feel about it?
Looking back, what are your happiest and most sad high school memories?
Do you wish you had done anything differently?
What was going on with your family during your high school years?
How did you spend your summers?
Did you earn any special honors in academics, sports etc?
Did you spend much time doing homework?
Looking back do you still hold the views that you held back then? If different now
explain what made your views change?
Did you have an after-school job?
What was going on in the world around you?
What did you plan to do after high school?
Have any of your classmates gone on to be famous or rich?
Besides academics, what life lessons did you learn in high school?
My Prom
(If you did not attend your prom, simply go on to the next section)

Did you attend prom?

Who did you go to the prom with?
Where did you go for prom night?
What friends did you hangout with?
(If female) Did you buy a special dress? Where did you get it? Describe the
dress.
(If male) What kind of planning did you do in getting ready for prom night? Limo?
Flowers? Etc

Class Reunions
I attended my reunion in (year). I’m going to talk about that now

Have you attended any of your reunions? If not why didn’t you go?
What was it like seeing your old friends?
Did you look forward or dread your reunion?
Did it live up to your expectations?
Who changed the most?
Did anyone become famous?
After attending how did you feel about your life’s accomplishment to that point in
life?
What would surprise your old school mates to learn about you now?
Did seeing them help you realized that you changed in ways that you were
unaware?
Had anyone from your class passed away that you were previously unaware of?

College & Advanced Training

I began college (or other type of trade school) at the age of

How many years of education have you completed?

Do you have a college degree? If so, what was your field of study?
Did you get good grades?
Which college did you attend and how did you choose that school?
Tell about your decision to go on to college.
What was your major field of study? Did you graduate?
How did you pay for your studies?
List some of the classes you took.
Who were some of your more memorable friends?
Which subjects where the easiest for you?
Did you have an active social life back then?
Did you date while in college?
Did you have to work to help pay for your schooling?
Did you become a member of any sorority or fraternity?
What did living away from home teach you?
Did you attend a trade school?
What type of career did you train for?
What were the benefits that trade school gave you that college wouldn’t have?
Were you easily able to find a job after trade school or college?
What was going on in the world while you attended college?

My Parents
My father’s full name is
He was born on (date)
In (place)

My mother’s full name is

She was born on (date)
In (place)

Your mother/father always said

What number was your father/mother among his/her brothers and sisters?
Who are his/her brothers and sisters? List them in order of birth.
Where did he/she grow up?
What stories does he/or she tell about their growing up years?
What was his or her childhood like?
What kind of work has he/she done?
Describe the appearance and characteristics of your mother/father.
What was his/her life like before meeting your mom/dad?
What kind of dreams did he/she have? Have they accomplished them?
What is your earliest recollection of your father/mother?
What sayings or expressions did he/she use often?
Tell about some of your favorite memories of your father/mother.
What things did you do together?
What traits in your parents do you see in yourself?
Have you learned anything about either of your parents’ earlier days, that
shocked you?
Was your parents’ relationship a strong one?
Which of them were you closer to?
When you were growing up, what was the biggest disagreement you ever had with your
parents?
Which parent do you look most like?
What traits and physical features did you “inherit” from each of your parents?
What have been his/her biggest accomplishments?
My Parents Together
My Parents were married at (place)
On (date)

How did your parents meet? (How, when and where)

How long did they date?
Do your parents tell any stories from their wedding or honeymoon?
Where did they make their first home?
At what age did they marry?
What stories have you heard from their early years together?
Can you describe what your parents looked like at that time?
How did they earn a living?
If they passed away where and how did it happen?
Where are they buried?

Divorce
Did your parents divorce?
-How old were you when they divorced?
-Did you understand what was happening?
-Did you blame yourself?
-Did you have to choose which parent to live with or was that decided for you?
-Did you ever do anything in hopes of making your parents fall in love again?
-Did your parent(s) remarry?
-What was it like getting use to other family members (i.e. step-brothers and
step-sisters)?
-Did the whole divorce experience make you shy about getting married yourself?
-Did it affect you emotionally in other areas of your life?

Brothers & Sisters

Now I’m going to talk a little bit about my brother(s) and sister(s) in order of
their births.”

(Name) was born on (date)

In (place of birth)

(Name) was born on (date)

In (place of birth)

What were your siblings like back then, and how did you get along with them?
What traits do you share with your siblings?
What traits don’t you share?
Who do you resemble the most physically?
What is your earliest memory of this brother/sister?
Do you know anything about his/her birth?
How did you two get along?
Did he/she go by any nicknames? How did they come by it?
What sort of dreams and ambitions did he/she have while growing up?
How did he/she do in school?
Do you remember any special family occasions where he/she was involved?
What special talents does he/she have?
What has he or she done since leaving home?
What does he/she do for a living?
What sort of hardships did he/she have to overcome?
Is he/she married?
Who is he/she married to (include maiden name)?
When and where did this marriage occur?
Do you recall anything about his/her dating years?
Where did they make their first home?
Who are his/her children and when where they born?
Did this marriage end in divorce? If so, when?
Where does he/she live now and what are they doing?
Has he/she died? If so what happened and when?
Where is he/she buried?

Aunts and Uncles

I’m now going to talk about my aunts and uncles on my mother’s/father’s
side.”

Who are your mother’s/father’s brothers and sisters? List them in order of their
births.
Do you remember, or have you been told, anything from their younger days?
What are they like now as adults?
Do you remember any special family occasions where he/she was involved?
What does he/she do for a living?
How did they get along with the rest of the family?
Is he/she married?
Who is he/she married to (include maiden names)?
When and where did this marriage occur?
Who are their children? (Your cousins).
What stories can you tell about these aunts, uncles and cousins?
Where does he/she live now and what are they doing?
Has he/she died? What happened and when?
If he/she has died, where is he/she buried?
Grandparents
Next I’m going to tell what I know/ remember about my grandparents.
My Mother’s/ Father’s mother/father is/was (name)
And she/he was born on in (place of birth)

Do you remember hearing your grandparents describe their lives? What did they
say?
Do you remember your great-grandparents? What do you know about them?
What are the greatest things about your grandma/grandpa?
Describe their appearance.
Do you have memories of spending time at your grandparent’s home?
What did he/she do for a living?
Do you know anything about his/her parents (your great-grandparents)?
How did they meet and fall in love?
How long did they date before they married?
What are some things that he/she taught you?
Do you think you’ve inherited any characteristics from any of them?
Did you live near or far from your grandparents?
Have your grandparents told you stories about your parents?
Did your grandparents keep journals? If so, who possesses them?
Do/did your grandparents carry out any ethnic customs?
How did he/she most typically dress?
Were/are your grandparent’s religious? What church did/do they attend?

Military Service
At the age of
I joined the (branch)

How did you decide which branch of the military to join?

How long did you serve? From when to when did you serve?
At what age did you join?
Did you enlist or were you drafted?
Where did you attend basic training or officer training?
What was basic training like? Easier or harder than you expected?
Tell about your drill/training instructor
Was it hard to be away from home? What did you miss most about home?
What kind of camaraderie did you experience?
What did your friends and family feel about you joining/being drafted?
Tell about your recruiter.
From what town or city did you join?
Do you have any service friends that you still keep in touch with?
What was the most difficult transition for you to military life?
What did you like most and least about military service?
Did you make the military a career? Why or why not?
Describe your progression in the military. What rank did you attain?
What where your duties?
Describe a typical day…in basic training and afterwards.
What were you trained to do?
What was your military pay at the time?
What units where you assigned to?
What where your fellow servicemen like?
List all the bases you were assigned to. Which did you like the most and the
least?
What was base life like? The barracks? Mess/Dining hall? Base housing?
Were you ever at sea? Describe life on a ship or submarine
What did you do in your off-duty time? Did you travel much? Where did you go?
Was romance a part of your military experience?
Was life in the military what you expected?
Tell about your most difficult times in the military.
Did you experience combat? Tell of some of the situations you faced.
Were you ever deployed? Where, how long, what was life like there?
What military campaigns were you involved in? WWII? Korea? Vietnam? Desert
Storm? Others?
Did you travel to or live in a foreign country? What was it like? How did the locals
treat the military?
Were you honored with any awards or decorations? I.e. Purple Heart, Service
Cross?
Was it difficult adjusting back to civilian life?
What did you do after leaving military service?
In what ways are you a different person now, because of military service?
Would you recommend military service to young people today?
Do you belong to any veteran’s groups?
If you served in the military, when and where did you serve and what were your
duties?
If you served in the military, were you ever injured in the line of duty?
What were the circumstances and what were your injuries?

Dating
I met (spouse’s full name)
At (location)
On (date)

How old were you when you started dating?

Do you remember your first date? Describe the circumstances.
Name a good friend that you have known for the longest period of time? How
many years have you been friends?
Has there ever been anyone in your life that you would consider to me your
kindred spirit or soul mate?
If so, who were they and why did you feel a special bond to them? Tell of the
circumstances of your first meeting your future spouse?
How old were the two of you when you met?
What did he/she look like?
What was his/her situation in life like at that time?
What was your situation in life like at the time?
What was your first impression of him/her?
Tell some dating stories.
Tell about your first kiss!
What did you do and where did you go on your dates?
Tell of the circumstances surrounding the proposal.
How long did the two of you date before you married?
Did either of you have doubts about getting married?
When and where were you married?
Share memories from your wedding and honeymoon.
Who attended your wedding?
What dating rules did your parents set out for you to live by?
What standards did you set for yourself? I.e. No kissing on the first date etc…
How old were you when you first dated?
Did you double date? Who was the other couple?
Do you have any embarrassing dating stories to tell?
Where did you go on your dates? Movies? High school events?
What song(s) remind you of your earlier days together?
What is the most romantic thing you ever did?
What was the most romantic thing that someone surprised you with?
What is the furthest distance you’ve traveled to be with somebody you desired?
What concerned you the most when you introduced your future spouse to your
parents?

Attraction!
What perfumes or fragrances remind you of someone you’ve been in love with or
someone special?
What physical feature are you most often complemented about?
What do you feel is your most attractive feature?
You regret that you never had a relationship with this person.
The farthest you’ve traveled to be with someone you desired?
If you could magically change one thing about your physical appearance, it would
be?
Tell about a compliment that made you blush.

My Spouse and Our Marriage

“Now I’m going to tell you about my husband/wife (name of spouse)
He/she was born in (place of birth) on (date of birth) ”.
How did you meet the person that you would later marry? Describe them?
Do you remember where you went on the first date with your spouse?
How long did you know them before you got married?
Describe your wedding proposal.
When and where did you get married?
Describe your wedding ceremony. Who was there?
Did you have a honeymoon? If so, where did you go?
How would you describe your spouse? What do (did) you admire most about
them?
How long have you been married (or were you married)?
What wise advice would you give to a grandchild on their wedding day?
What number was he/she among his/her brothers and sisters?
Who are his/her parents? Tell about them.
Who are your wife’s/husband’s brothers and sisters?
What do you know about his/her early growing up years?
What color are his/her eyes?
What color is his/her hair?
Where did your spouse grow up?
Was his/her family a religious family?
Know any stories from his/her childhood?
What kind of schooling has he/she had?
What dreams and ambitions did he/she hold early on?
What did your spouse do between the time he/she left home and married?
What is his/her heritage or ethnicity?
How did his/her parents make a living?
What influenced you most in your choice of spouse?
Did you have any common friends? Who were they and did they play a role?
Did your parents support your engagement or were they against it?
How did their support, or lack of it, affect your relationship with your sweetie?
After your marriage did your parent’s opinions change at all?
What about your spouse attracted you?
What do you suppose attracted your spouse to YOU?
What were the words you first said to your spouse?
Did anything unusual happen during your wedding?
Who participated in your wedding? (I.e. Best man, bridesmaid etc…)
Did you have a ring bearer or a flower girl?
Was your wedding elaborate or simple?
Was it a religious ceremony or civil?
Describe your reception. What rituals were observed? I.e. cutting the cake etc.
What traits did you and your spouse have in common?
What differences did the two of you have?
How did these things, common and different, affect your relationship?
What expectations of marriage did you have? For example, you’d never argue
with each other, you’d never go to bed mad at each other?
Did you marry your spouse thinking that he/she would change or that you could
change them?
If so, did they change or did you have to adjust?
Did you feel you had to give up anything when you married? I.e. your
independence, a career, your close friends?
What do you feel you gained when you married?
Tell about first meeting your in-laws.
How accepting of you were they? Did they welcome you to the family with open
arms or was there resistance?
What does/did your spouse do for a living?
How did the two of you decide whom to spend the holidays with?
What kind of things did the two of you argue about early on and then later in your
in your marriage? Rearing children, money issues, political things?
Is (was) your marriage one of traditional roles? For example, did one of you fill
the breadwinner role while the other assumed a homemaker role? Did one or
both of you deal with the finances?
If you divorced, what do you attribute it to?
What do you believe to be the “secret” to a successful marriage?
Where did you first live as a married couple?
Can you describe details of life during that time?
What did the two of you do to make a living then?
Mention the costs of housing and wages at that time.
What did you two do for entertainment?
Where have you lived since then?
What were your thoughts on having children when you first got married?
Name all of your children that have come from this union.
What hardships have you both faced during your marriage?
What have been the joys and rewards of your marriage together?
Were you and your spouse in love from the start, or did the relationship take time?
When did you decide to have children?
Over the years, what was the most rewarding thing about raising kids? The toughest?
What do you remember as the best times you had as a family?
Which family vacation was your favorite?
What was the worst thing you went through with your family?
Did you dream about doing anything special once I’d/we’d all grown up?
What are the secrets to a good relationship or marriage?
Do you have any advice about being a good parent?
Is there anything you’d do differently as a mother/father now?
Would you try to do anything differently as a spouse?
What would you say love is? Have your ideas about it changed over time?
Now that you’re all adults, what are your relationships like with your siblings?
How are you like your parents? How are you different?
Who in the family is most like you?
What have you always regretted not asking your parents?
You and Me
Is there anything you’ve never been able to ask me or say to me?
In what ways do you think we’re similar? In what ways different?
What were your favorite times with me?
Is our relationship anything like the one you had with your parents?
Are you happy with the way you and I get along?
Is there anything you wish had been different between us? That you’d still like to
change?

(If you are still married to this spouse, please go on to the next section. If this
marriage ended either in death or divorce, please give details and repeat the
questions for each additional spouse.)

Our Children
Our [first] child (full name)
Was born on (birth date)
In (place of birth)

“At the time of (name) ’s birth, we were living in (place you lived at the time
of his/her birth) .”

Does/did this child go by a nickname?

What is the child’s father’s/mother’s full name?
How was the family making a living at the time?
How did the family react when they were told of the pregnancy?
What was this child’s birth length and weight?
What did this child look like at birth? (Example: hair, no hair etc.)
Was this child named after anyone?
What time was the actual birth and what were some of the circumstances
surrounding the birth?
Were there any health concerns surrounding this child’s first few months?
Who was present at his/her birth?
Describe bringing your baby home for the first time?
If this was not your first, who watched your other children while you were at the
hospital?
How did becoming a parent change you?
Recall what you can remember from the pregnancy. Was it a hard one? Did
you/spouse have morning sickness? Experience any strange food cravings?
What is the current age of this child?
What is this child’s current height?
At what age did this child learn to talk, crawl, walk, potty train and read?
Who were some of his/her childhood friends?
What are the sweetest memories you have of your child when he/she was
young?
What accomplishment(s) of this child are you the most proud of?
What education level did he/she reach or what grade are they currently in?
Tell about your child’s grade school years.
Did you ever have any problems with any of their teachers?
Did you help them with their homework often?
As teenagers, what did you argue with your children about?
Dating, curfews etc?
What did this child want to be when he/she grew up?
What did this child do after he/she left home?
Under what conditions did this child leave home? (Marriage, college, armed
forces, bad circumstances etc…?)
Who has this child married?
Who are his/her children?
What things do/did your children do that makes/made you laugh?
Do you notice your adult children carrying on traditions they learned as
youngsters?
Do you notice your adult children doing anything better than what you did as a
parent?
What kind of values did/are you trying to instill in your children?
Did you and other family members agree on how children should be raised?
Is there anything else you’d like to say about this child?

Sons and Daughters-In-Law

My son/daughter
Married (spouse’s name)
On (marriage date)

Describe and characterize this son/daughter-in-law.

Where is he/she originally from?
What is his/her work and educational background?
Where did your child meet him/her?
Who are his/her parents? Tell a little bit about them and where do they live?
Describe their dating period.
What was your reaction to their engagement?
If this marriage ended, describe the circumstances and how it affected members
of your family.
Has your child remarried?

Our Grandchildren
“I am now going to talk about my grandchildren beginning with the first
grandchild.”

“The full name of my [first] grandchild is .”

(Substitute the appropriate birth order of each grandchild between the red
brackets […]

Who are his/her parents?

Where and when was this grandchild born?
Who does this grandchild most resemble in the family?
What are your first/most cherished memories of this grandchild’s younger years?
What where your thoughts upon becoming a grandparent?
What where the circumstances surrounding his/her birth?
What best describes this grandchild?
What stories can you tell about this grandchild?
What kind of role have you played in this child’s life?
How old is this particular grandchild today?
Where does this grandchild live today and what is he/she doing?
What are my hopes and dreams for this grandchild?
What more can you say about this particular grandchild?
How did you first hear that you were a grandparent and how did you feel about
it?
What advice do you have for your children and grandchildren?

Advice for Grandchildren and Future Generations

What advice do you have about any or all of the topics below?
Here is your chance to share and preserve some of your hard-earned wisdom with
your children, grandchildren and other future descendants. Be honest and open about
your answers. Your knowledge and wisdom here could help your posterity not have to
“reinvent the wagon wheel”.

Raising Children
Love and Marriage
Money
Career
Education
Additional advice you’d like to give:

Work History and Career

“Now I’m going to tell about my work history which encompasses (total
number of years worked).”
COMPANY WORKED
What did you want to be when you were a kid?
How did you decide on a career path once you were older?
At what age did you begin working?
Talk about the wages and working conditions of each of your jobs held.
How did you typically find your jobs? Newspaper ad? Did your family have
connections?
Did you ever have to move to take a new job?
If you had to live away from family, because of your work, how did you keep in
touch and how often?
Who’s the worst boss you ever had? Why was he/she the worst?
Who were your favorite/most memorable co-workers over the years? Do you still
keep in touch with them?
If you could snap your fingers and change jobs tomorrow, what would you be?
(Qualifications and education no being a factor)
What about your career has been the most satisfying?
Looking back, what would you change when it came to career preparation?
Describe a typical day in your current job.
What are the top 5 jobs that you’d want your children to do? Why?
What are 5 jobs that you’d steer your children away from? Why?
What has the word “success” meant to you in the past and what does it mean to
you today?
What was your first job, and how did you get it?
How did you decide what field to enter?
Did your parents influence your approach to work or your choice of career?
Was money a big factor for you?
Was there one person—a mentor,maybe—who had a big impact on your working life?
Is there anything you think is absolutely crucial to success at work?
What was the best job you ever had? The worst?
When you were a kid, what did you imagine your adult life would be like?
Did your career have any major turning points?
What were the best moments of your working life? Any lingering regrets?
On balance, how did you like your chosen field?
If you had it all to do over again, would you choose the same path?
As a child, what did you want to be when you grew up?
What was your first job?
What kinds of jobs have you had?
How did you decide on your career?
Did you make enough money to live comfortably?
How long did you have to work each day at your job?
How old were you when you retired?

How many hours per week do/did you work?

[ ] I wish I worked less [ ] I wish I worked more

My Own Business
“I began my own business in (year started)”

What is the name of your business and what type of business is it?
Why did you decide to go into business for yourself?
How did you choose the particular business that you did?
Describe your business in the beginning.
Give a year by year accounting of the growth and changes in your business.
What do you see for your business and the future?
At what age do you hope to retire?

Religion
Do you believe in God?
Do you believe in an after life?
Describe your religious beliefs.
What role has religion played in your life?
What church did you attend as a child with your parents?
Do you attend church now as an adult?
If you do attend, do you attend the same denomination today?
Have you ever spent any time as a missionary? If you have, where did you serve
and for how long? Tell of some of your experiences.
What role has religion played in your family’s development?
What are some of your earliest recollections of religious practices and
ceremonies?

Travels and Vacations

Name all of the States and countries that you have visited in your lifetime.
Do you travel much and do you enjoy it?
Where are some of the more memorable places you’ve traveled to?
What is the nature of most of your trips? Business? Pleasure?
By what means and with whom did you travel?
Where do you usually stay?
What things do you always take with you when you travel?
Describe the interesting people you’ve met along the way.
What places have you seen along the way?
How has travel changed in your lifetime?
What is the most beautiful place you have ever visited and what was it like?
What is the longest trip that you have ever gone on? Where did you go?
What has been your favorite vacation? Where did you go and why was it special?
What was the favorite place you ever visited and what was it like?

Miscellaneous
Have you ever been robbed or held up?
What do you believe will be the major world events of the next decade?
If you could cure one disease which one would you cure? Why?
If a movie was made of your life, who would you want to play your part?
If there was one person from your past, who you have lost contact with, that
you’d like to find again, who would it be and why?
How has the world changed in your lifetime?
What inventions have you seen come about? For example, car, airplane, VCR,
Internet, remote control etc… Tell about your experiences with these items and
others.
You as You
• Who knows you better than anyone?
• Other than family, who are the most important people in your life right now?
• What’s the key to a great friendship?
• Who makes you laugh the hardest?
• What was the best trip you ever took?
• The most amazing place you’ve seen?
• If you could go somewhere you’ve never been, where would it be?
• Would you rather be living somewhere else?
• What are five things you couldn’t live without?
• What’s your most beloved personal possession?
• What’s the bravest thing you’ve ever done? The scariest? The dumbest?
• Is there anything you always wanted to do but never did?
• What would I be surprised to learn about you?
• What is one item you own that you really should throw away…but probably never
will?
• What moment are you most proud?
• What one event has changed your life more than anything else?
• What one special talent would you like to have?
• What is the best decision you have made in your life?
• What was the best part of your day? The worst part of your day?
• What was the best thing that happened to you this past week?
• What was your most embarrassing moment?
• What is the greatest lesson in life you have ever learned?
• What is the greatest risk you have taken in your life?
• What is something (not someone) that “bugs” you?
• What is something really important to you and why?
• What is something you forgot once that you will never forget again?
• What is something you want to learn how to do and why?
• What is something you want to learn more about? Why?
• Do you learn more when you win or when you lose?
• Do you think you are a good friend?
• Does your life feel too busy? On a scale of 1-10
• Which chores do you like to do and which don’t you like to do around the
household?
• Who did you talk to or sit with at lunch today?
• What type circumstances do you find it hard to say no?
• What type circumstances do you find it hard to say yes?
• What do you remember about your first day of school/work?
• What is the most difficult thing you ever had to do?
• What is challenging for you?
• Name one thing you really like about yourself.
• Name something kind you did today.
• Name two strengths you have.
 • What happened to you today?
• What is one good thing that happened to you today?
• What is your most valued possession? Why?
• What do you value most about yourself?
• What is your most vivid dream?
• What would you consider to be the most important inventions that have
been made during your lifetime?
• How is the world now different from what it was like when you were a
child?
• Were there any fads during your youth that you remember vividly?
• What were the hardest choices that you ever had to make? Do you feel
like you made the right choices?
• Who was the person that had the most positive influence on your life?
Who were they and what did they do?
• Is there a person that really changed the course of your life by something
that they did? Who were they and what did they do?
• Do you remember someone saying something to you that had a big
impact on how you lived your life? What was it?
• What was the most stressful experience that you ever lived through?
What helped you get through it?
• What is the scariest thing that has ever happened to you personally?
• What kinds of musical instrument(s) have you learned to play?
• Would you consider yourself creative?
• What things have you made that others have enjoyed?
• How would you describe your sense of humor?
• What is the funniest practical joke you ever played on anyone?
• What activities have you especially enjoyed as an adult?
• What are your hobbies?
• What did you like to do when you were not working?
• What is the most amazing thing that has ever happened to you?
• What is the most embarrassing thing that has ever happened to you?
• Have you ever met any famous people? Describe what happened.
• What organizations and groups have you belonged to?
• Have you ever won any special awards or prizes as an adult? What were
they for?
• Is there anything you have always wanted to do, but haven't?
• Describe a time and place when you remember feeling truly at peace and
happy to be alive. Where were you and what were you doing?

The Kind of Life You’ve Lived

• What were the best years of your life?
• What was the hardest decision you’ve made?
• What are the most important things in life?
• What do you consider to be your strongest character traits?
 • What traits or habits do you wish you didn’t have?
• Do you believe that people can change?
• Has life made you more cynical or more hopeful?
• What do you consider to be the most important world events of your lifetime?
• Do you think life now is harder or easier than when you were young?
• If you could do anything over in your life, what would it be, and what would you
do differently?
• What are you most proud of?
• What do you hope to be remembered for?

Friends & Associates

1.
2.
3.
4.
5.

List Your Favorite:

What is your favorite…and why?

1. What is your favorite style of music?

2. What is your favorite musical instrument?
3. Who is your favorite musical group?
4. Who is your favorite musician?
5. What is your favorite song?
6. Who is your favorite singer?
7. Who is your favorite movie star?
8. Who is your favorite actor?
9. Who is your favorite actress?
10. Who is your favorite politician?
11. What is your favorite radio station?
12. What is your favorite kind of movie?
13. What is your favorite movie?
14. What is your favorite Theatre Play?
15. What is your favorite painting?
16. Who is your favorite artist?
17. What is your favorite book?
18. Who is your favorite author?
19. Who is your favorite character from literature?
20. Who is your favorite super-hero?
21. What is your favorite magazine?
22. What is your favorite poem?
23. Who is your favorite poet?
24. What's your favorite English word?
25. What’s your favorite English Idiom?
26. What’s your favorite Foreign Language?
27. What’s your favorite foreign word or phrase?
28. What is your favorite TV program (as an adult)?
29. What is your favorite TV program (as a kid)?
30. Who's your favorite cartoon character?
31. What is your favorite Web site?
32. What is your favorite time of day?
33. What is your favorite season?
34. What is your favorite tree?
35. What is your favorite flower?
36. What is your favorite holiday?
37. What's your favorite thing to do in the summer?
38. What is your favorite color?
39. What is your favorite day of the week?
40. What is your favorite thing to do inside?
41. What is your favorite thing to do outside?
42. What was your favorite family activity?
43. What was your favorite family vacation?
44. What is your favorite city in the United States?
45. What is your favorite country (outside the US)?
46. What is your favorite Place you’ve lived?
47. What is your favorite Body of Water?
48. What is your favorite City on each Continent?
49. What is your favorite Scenic View?
50. What is your favorite Clothing to wear?
51. What is your favorite way to relax?
52. What is your favorite way to spend a lazy Saturday?
53. What’s your favorite physical activity and why?
54. What is your favorite type of car?
55. What is your favorite sport?
56. Who is your favorite athlete?
57. What is your favorite animal?
58. What is your favorite type of dog?
59. What is your favorite type of bird?
60. What's your favorite smell?
61. What's your favorite flower?
62. What's your favorite perfume?
63. What is your favorite meal?
64. What is your favorite kind of food?
65. What is your favorite kind of ethnic food?
66. What is your favorite fruit?
67. What is your favorite vegetable?
68. What is your favorite candy?
69. What is your favorite cookie?
70. What is your favorite Kitchen Spice?
71. What is your favorite drink?
72. What is your favorite soft drink?
73. What is your favorite restaurant?
74. What is your favorite flavor of ice cream?
75. What is your favorite board game?
76. What is your favorite card game?
77. What is your favorite video game?
78. What is your favorite memory of childhood?
79. Who was your favorite teacher? Why?
80. ....in high school?
81. ...in junior high school?
82. ...in elementary school?
83. What was your favorite subject in school?
84. ....in high school?
85. ...in junior high school?
86. ...in elementary school?

Family “Awards”
Consider yourself, spouse, parents, brothers, sisters, cousins, aunts and uncles,
your children etc. Who fits the following descriptions best? Be sure to mention
the person’s relationship to you and, if you can, explain why you put their name
down. Give a short example of their behavior that garnered them these titles!

Best career
Best cook
Best gardener
Best housekeeper
Best looking
Best memory
Best story teller
Biggest animal lover
Biggest tease
Calmest
Craziest
Funniest
Hardest worker
Longevity Award – Oldest family member that you’ve known or been told about
Most “crafty”
Most athletic
Most cautious
Most colorful
Most creative
Most educated
Most enterprising
Most frugal
Most generous
Most humble and/or grateful
Most intelligent
Most kind
Most mischievous
Most mischievous
Most muscular build
Most organized
Most politically-active
Most rebellious
Most reclusive
Most relaxed
Most religious
Most scholarly
Most sociable
Most traveled
Quietest
Shortest
Tallest
Wildest lifestyle

Lists!
1. List 25 things that you’ve yet to do but still plan to do in your lifetime.
2. List a funny thing that has happened to you and a friend
3. List all of the contents that are currently in your pockets, wallet and or purse.
4. List all of the leaders of your country that have served during your lifetime.
5. List all of the pets that you’ve ever owned.
6. List all the great ideas that are in your mind right now
7. List all the places that you have yet to visit but desperately want to someday!
8. List all the projects that you are in the middle of but haven’t completed
9. List all the sounds around you right now!
10. List all the values that you adhere to
11. List all the vehicles that you and your parents have owned:
12. List any brushes with fame that you’ve had
13. List any celebrities that you’ve seen in person
14. List any volunteer jobs that you’ve had
15. List dates that are important and have meaning in your life!
16. List every organization in which you have been a MEMBER or still are!
17. List everything that you once collected or still do collect.
18. List foods that you won’t eat!
19. List musicians and music groups that you love now
20. List musicians and music groups that you loved as a kid
21. List of everything that is within 10 feet of you!
22. List old friends you’ve lost contact with but would like to see again!
23. List people that you thought you would marry but did not
24. List people who you wished you had not trusted
25. List people who you’d like to be your friend but are not…why?
26. List places that have meaning to you?
27. List places that you’d like to retire to…and why
28. List songs or music that has meaning to you!
29. List ten things about you that you would like your descendants to know
30. List the brand names that you use and swear by
31. List the career(s) that you sometimes wish you had chosen!
32. List the celebrities that you’ve seen in person!
33. List the compliments you receive on a regular basis!
34. List the gifts from friends that meant the most to you
35. List the gifts from your parents that have meant the most to you
36. List the greatest inventions that have been invented in your lifetime!
37. List the lessons you’ve learned the hard way!
38. List the magazines that you have subscribed to
39. List the magazines, books, articles and topics you are reading currently.
40. List the most recent things you have learned
41. List the people that have betrayed you
42. List the people that have had the biggest impact in your life. How?
43. List the places that you’d love to live and escape the chaos of the world
44. List the presidents that you have voted for
45. List the risks that you regret not taking and how would things be different?
46. List the rules you MUST FOLLOW to date my son or daughter!
47. List the things that you hide when someone comes to visit
48. List the things that you still have and hold dear from your childhood!
49. List the things that you wish you knew the truth about!
50. List the things that you’d like to change about yourself!
51. List the things you hide when someone comes to visit!
52. List the things you own that should be passed down to other generations!
53. List the times in your past that you’d like to go back to!
54. List the times that you’ve cried your eyes out!
55. List the times you’ve been thoroughly surprised!
56. List the ways in which the world has changed in your lifetime!
57. List the ways in which you live better than most people you know!
58. List the ways in which you live worse than most people you know!
59. List the ways that you learn best
60. List the ways you are “just like” your father and mother (two lists).
61. List the ways you are not at all like your father and mother (two lists).
62. List things that convinced you most in your choice of spouse!
63. List things that you are NOT good at!
64. List things that you don’t like that “most” others do!
65. List things that you have purchased and like to purchase online!
66. List things that you like better in today’s era over the era in which you grew up!
67. List things that you like that “most” others don’t!
68. List things that you liked better about living in the era you grew up in!
69. List things you enjoy talking, reading and learning about!
70. List things you had to give up or put aside when you fell in love with your spouse.
71. List things you’ve only experienced once in your life!
72. List what you would have done differently in your life, if you’d known then what you
know now?
73. List what you are good at!
74. List what you hope your life will be like 10 years from now!
75. List what you plan to do when you retire!
76. List what you think about just prior to falling asleep at night
77. List what you worry about the most!
78. List what you would do if you had no fear
79. List what you’d do with a sudden windfall of $5 million dollars!
80. List what’s in you closet that you can’t bear to part with!
81. List your favorite foods that your mother use to prepare when you were a child!
82. List your favorite family recipes!
83. List your favorite web sites and things to do online!
84. List your personal “Top 25” movies of all time!
85. List your possessions that you could not live without
86. List your proudest accomplishments
87. What bridges have you burned?
88. What does it take to get on your spouse’s “good side” (cheer him/her up)!

Inventory Lists
Key Chain
Your Junk Drawer
Storage Closets
Your Pockets
Your Purse
Your Car
The Desk Draw
Computer Software
Bookshelf
Garage or Tool/Storage Shed
Keepsake Box
Home Movies
Photo albums
Gun Cabinet
CD collection
Your Barn
Medicine Cabinet
Clothes
Your Yard
The People in Your Office
The People in Your Neighborhood

First Time for Everything!

Life is full of first-time experiences.

1. First Kiss
2. First serious romance
3. Plane Ride
4. Car of your Own
5. First Received Drivers License
6. First Used the Internet
7. First Item Bought Online
8. Bought/Used a Cell Phone
9. Bought/Used a Microwave
10. First Bicycle
11. First Pet
12. First Job/Pay Check
13. First “Best” Friend
14. First Voted
15. First Concert
16. First Apartment
17. Purchased a Home
18. First Love
19. First Time Shaving
20. First Barbershop Haircut
21. First Lost/Pulled Tooth
22. First Hunting Trip
23. Christmas/Hanukkah Away From Home
24. Day at a New School
25. Traffic Ticket
26. Court Appearance
27. First Became a Parent
28. First Deceased Person You Saw
29. First Received Flowers

Social Circles
In a social setting I:
[ ] tend to introduce myself [ ] tend to wait for others to introduce themselves
When you are attracted to someone I:
[ ] prefer to be the pursuer [ ] prefer be the one pursued

I am most comfortable:
[ ] by myself [ ] at work [ ] just watching others
[ ] with one other person [ ] socializing with a group of people

In my relationships:
[ ] I tend to make most of the decisions
[ ] I do not make most of the decisions

I love it when people ask me this:

I hate it when people ask me this:

Values and Beliefs

What are your feelings on…?

Aids
Abortion
Divorce
Death Penalty
Pornography
Mandatory Military Service
UFOs
Life On Other Planets
Homosexuality
Discrimination
Death & Dying
Monogamous Relationships
Life after Death
Proper Dating Age/Rules
Legalization of Drugs

Which issue concerns you the most?

(Choose one from above or one of your own.)
What have you done to support this issue?
[ ] I’ve donated money
[ ] I’ve donated my time
[ ] I’ve done nothing but plan to

Politics & Social Issues

Where do you stand on these topics?
How would you describe yourself politically?
Are you Conservative or Liberal and why?
What wars have been fought during your lifetime? How did you feel about
them?
What U.S. President have you admired the most and why?
As you see it, what are the biggest problems that face our nation and how
do you think they could be solved?
Who spends your money better, you or the government?
Taxes, out of control?
Do you believe in any government conspiracies?
Do you really worry about overpopulation?
Ozone hole, real or junk science?
Foreign Policy
Environmental movement, is it earth worship?
Do you believe in recycling?
Gun Control
Public Schools, give your grade
Endangered Species
Paying Taxes
Politically I define myself as
[ ] conservative [ ] liberal [ ] moderate [ ] other

Easy Daily Journal

Today’s Date
Day of the Week
Today’s Weather
I went to
Where I was most of the day
I’m Reading
I’m Watching
I’m Excited About
I’m Wearing
I’m Eating/Drinking
I’m Hearing
I’m Dreaming About
I’m Learning
Talked to
Sent/Received Email from
Made me happy
Made me mad
Accomplished
Remembering
Planning

Introspect Questionnaire
I shop heavily with coupons [ ] yes [ ] no
I like to cook [ ] yes [ ] no
I read a newspaper everyday [ ] yes [ ] no
I’m an early riser [ ] yes [ ] no
I am grumpy in the morning [ ] yes [ ] no
I’m a vegetarian [ ] yes [ ] no
I’m a smoker [ ] yes [ ] no
I eat too fast [ ] yes [ ] no
I am a recycler [ ] yes [ ] no
I like to play card games [ ] yes [ ] no
I often have people at the house [ ] yes [ ] no
I’m spontaneous [ ] yes [ ] no
I like crossword puzzles [ ] yes [ ] no
I can whistle [ ] yes [ ] no
I like being on the phone [ ] yes [ ] no
I’m often late [ ] yes [ ] no
I’m a shopoholic [ ] yes [ ] no
I read in the bathroom [ ] yes [ ] no
I often get headaches [ ] yes [ ] no
I own a cellphone [ ] yes [ ] no
I talk in my sleep [ ] yes [ ] no
I’m told I snore a lot [ ] yes [ ] no
I usually have to have the last word [ ] yes [ ] no
I know who I am [ ] yes [ ] no
I get out of bed immediately with the alarm [ ] yes [ ] no
I have fired a gun [ ] yes [ ] no
I don’t mind being photographed [ ] yes [ ] no
I’ve flown in an airplane [ ] yes [ ] no
I’ve forgotten more than one anniversary [ ] yes [ ] no
I’m a morning person [ ] yes [ ] no
I’m a night owl [ ] yes [ ] no
I’ve gone to movies alone [ ] yes [ ] no
I always have a book I’m reading [ ] yes [ ] no
I’m entrepreneurial-minded [ ] yes [ ] no
I save old letters and postcards [ ] yes [ ] no
I’m a fast talker (smooth talker) [ ] yes [ ] no
I often speak before I think [ ] yes [ ] no
I write letters regularly [ ] yes [ ] no
I love the computer [ ] yes [ ] no
I go on walks often [ ] yes [ ] no
I fold my underwear [ ] yes [ ] no
I often say “I love you” [ ] yes [ ] no
Others would describe me as outgoing [ ] yes [ ] no
I drink alcohol [ ] yes [ ] no
I set my clocks a few minutes ahead [ ] yes [ ] no
I dream in color [ ] yes [ ] no
I generally like people [ ] yes [ ] no
I find it hard to tell people no [ ] yes [ ] no
I keep a diary or journal [ ] yes [ ] no
I exercise regularly [ ] yes [ ] no
I consider myself a romantic [ ] yes [ ] no
I fear public speaking [ ] yes [ ] no
I always wear my seat belt [ ] yes [ ] no
I love to dance [ ] yes [ ] no
I’m a good money manager [ ] yes [ ] no
I am frugal (thrifty) [ ] yes [ ] no
I play a musical instrument [ ] yes [ ] no

That Which I Fear

I fear:
Flying [ ] not at all [ ] moderately [ ] extremely
Comments:
Guns [ ] not at all [ ] moderately [ ] extremely
Comments:
Public Speaking [ ] not at all [ ] moderately [ ] extremely
Comments:
Losing my job [ ] not at all [ ] moderately [ ] extremely
Comments:
Snakes/Spiders/Bugs [ ] not at all [ ] moderately [ ] extremely
Comments:
Not being able to provide for the family
[ ] not at all [ ] moderately [ ] extremely
Comments:
Not being able to pay for kid’s college
[ ] not at all [ ] moderately [ ] extremely
Comments:
Growing old [ ] not at all [ ] moderately [ ] extremely
Comments:
Change in general [ ] not at all [ ] moderately [ ] extremely
Comments:
Heights [ ] not at all [ ] moderately [ ] extremely
Comments:
Going in the water [ ] not at all [ ] moderately [ ] extremely
Comments:
Additional Notes and Information:

My Medical History
My hearing is
My vision is

Have you ever had, been diagnosed or experienced any of the following?
Heart Disease [ ] yes [ ] no
Comment:
Heart Attack [ ] yes [ ] no
Comment:
High Blood Pressure [ ] yes [ ] no
Comment:
Respiratory Problems [ ] yes [ ] no
Comment:
Cancer [ ] yes [ ] no
Comment:
Drug or Food Allergies [ ] yes [ ] no
Comment:
“Bad Back” [ ] yes [ ] no
Comment:
Diabetes [ ] yes [ ] no
Comment
Physical Handicap [ ] yes [ ] no
Comment
Major Operation [ ] yes [ ] no
Comment
List the medications that you regularly take:
Describe your general health.
What major illnesses or health problems do you remember having?
Do you have any health problems that are considered hereditary in nature? If so,
what are they?
What do you do regularly for exercise?
Do you have any bad habits now or in the past? What were they?
Have you ever been the victim of a crime? What happened?
Have you ever been in a serious accident?
Has anyone ever saved your life? Describe.
Have you ever saved anyone else's life? Describe.
Have you ever been hospitalized? If so, what for?
Have you ever had surgery? If so, what for?
If you could change something about yourself, what would it be?
Have you ever had an experience that you would consider to be super-natural or
psychic? Did you ever know something was going to happen before it actually
did? What was it?
What do you usually dream about?

List any other medical conditions that you wish:

A Treasure Hunt!
Here are some ideas of what to look for:

1. Family Tree! Four Generation Pedigree Charts & Family Group Sheets
2. Old recipes that date back for years
3. Old rocks that may be in your yard that you picked up from places you’ve been
4. Old letters that you wrote but never sent
5. Old letter that you received
6. Papers from a job you use to hold
7. Lists of goals, success and achievements from the past
8. Travel brochures to places you’ve been
9. Travel brochures that you ordered for places you wanted visit but never did
10. Appliance guarantees for every appliance you ever purchased
11. Old newspaper clippings
12. Magazine pictures that you clipped out to remind you of things you enjoy
13. Poetry you’ve written
14. Children’s old report cards
15. Lock’s of hair
16. Old driver’s license
17. Drawings
18. Old photos that you never put into an album
19. Old craft project kits that you were sure that you’ve someday finish
20. Old books you’ve bought
21. Old calendars with notations about appointments, meetings and social events
22. Old wellness checkup paperwork showing your babies weights and measurements at
certain points in your babies first years
23. Dried flowers
24. Old clothes patterns
25. Your old high school varsity sports letter that never was sewn on a jacket
26. Old paintings from when you loved to paint
27. Favorite quotes that you collected. Why were they important to you back then?