do you like outdoor life?
do you have nightmares?
do you get tired of work?
do you get rattled easily?
do you usually sleep well?
have you a good appetite?
is it easy to get you angry?
can you stand pain quietly?
do you make friends easily?
have you ever seen a vision?
have you ever fainted away?
do your eyes often pain you?
is it easy to make you laugh?
have you often fainted away?
did you ever have convulsions?
are you troubled with shyness?
do you ever walk in your sleep?
are you afraid of responsibility?
can you stand disgusting smells?
do you have a great fear of fire?
did you have a happy childhood?
did you ever have anemia badly?
did you ever have heart disease?
can you stand the sight of blood?
do you usually feel well & strong?
can you sit still without fidgeting?
do you find your way about easily?
did you ever run away from home?
do you get tired of people quickly?
do you think tobacco has hurt you?
do you think drinking has hurt you?
do you feel tired most of the time?
does liquor make you quarrelsome?
have you ever had fits of dizziness?
are you bothered much by blushing?
do your interests change frequently?
is your head apt to ache on one side?
is it easy to get you cross or grouchy?
do you have too many sexual dreams?
do you get used to new places quickly?
do you feel well rested in the morning?
were you shy with other boys [or girls]?
has any of your family been a drunkard?
has any of your family had a drug habit?
were you considered a bad boy [or girl]?
did you ever have a nervous breakdown?
were you happy when 14 to 18 years old?
has your family always treated you right?
did you ever make love to a girl [or boy]?
did you ever have the habit of stuttering?
do you have a great many bad headaches?
has any of your family committed suicide?
did you ever have dyspepsia [indigestion]?
have you ever been afraid of going insane?
do you have continual itchings in the face?
do you worry too much about little things?
have you ever had any great mental shock?
do you have trouble in walking in the dark?
have you ever had an arm or leg paralyzed?
have you ever lost your memory for a time?
are you bothered by fluttering of the heart?
does it make you uneasy to go into a tunnel?
do you often have the feeling of suffocating?
did the other children let you play with them?
are you troubled with dreams about your work?
did you ever have the habit of wetting the bed?
have you ever been unfaithful to a girl [or boy]?
do you feel sad or low-spirited most of the time?
have your employers generally treated you right?
did you ever have asthma or hay fever [allergies]?
do you ever feel a strong desire to go steal things?
can you do good work while people are looking on?
did the teachers in school generally treat you right?
are you often frightened in the middle of the night?
do you usually know just what you want to do next?
did you ever have a strong desire to commit suicide?
have you hurt yourself by masturbation (self-abuse)?
do you often have bad pains in any part of the body?
do people find fault with you more than you deserve?
do you know of anybody who is trying to do you harm?
did you ever have the habit of biting your finger nails?
does it make you uneasy to cross a bridge over a river?
do you ever feel an awful pressure in or about the head?
do you have the sensation of falling when going to sleep?
do ideas run through your head so that you cannot sleep?
did you ever have the habit of taking any form of "dope"?
did you ever have a strong desire to run away from home?
do you feel like jumping off when you are on a high place?
do things ever seem to swim or get misty before your eyes?
are you ever bothered by a feeling that things are not real?
are you troubled with the fear of being crushed in a crowd?
do you ever feel a strong desire to go & set fire to something?
do you find it difficult to pass urine in the presence of others?
have you ever been blind, half-blind, deaf or dumb for a time?
do you have queer, unpleasant feelings in any part of the body?
did you ever think you had lost your manhood [or womanhood]?
has any of your family been insane, epileptic, or feebleminded?
do you think you have too much trouble in making up your mind?
do you ever have a queer feeling as if you were not your old self?
does your heart ever thump in your ears so that you cannot sleep?
does it make you uneasy to sit in a small room with the door shut?
can you do the little chores of the day without worrying over them?
did you ever have the habit of twitching your face, neck or shoulders?
does it make you uneasy to have to cross a wide street or open square?
are you troubled at night with the idea that somebody is following you?
did you ever have st vitus's dance [sydenham's chorea —you would know]?
do you feel you must do a thing over several times before you can drop it?
does your mind wander badly so that you lose track of what you are doing?
are you troubled with the idea that people are watching you on the street?
as a child did you like to play alone better than to play with other children?
are you ever bothered by the feeling that people are reading your thoughts?
do you think you have hurt yourself by going too much with women [or men]?
does some particular useless thought keep coming into your mind to bother you?
do you think you worry too much when you have an unfinished job on your hands?
have you ever felt as if someone was hypnotizing you & making you act against your will?
do your feelings keep changing from happy to sad & from sad to happy without any reason?
