Dream Incubation Research Experiment

Feedback Form

Personal Information

First Name
Last Name
E-mail
Age
Male Female

Address
City
State/Province
Zip/Postal Code
Country
Home Phone
Work Phone

Occupation
Native Language

How often do you currently recall dreams?
(a) rarely

(b) 1 / month

(c) 1 / week

(d) 2-4 / week

(e) one / night

(f) 2-3 / night

(g) 4 or more per night

How often do you currently have lucid dreams? (A lucid dream is one where you know that it's a dream and guide it consciously.)

(a) never

(b) 1 / year

(c) a few a year

(d) 1 / month

(e) 1 / week

(f) 2-4 / week

(g) 1 / night

Incubation Results
All submitted results will remain confidential though they may be used anonymously for statistical research. Beyond this, do you give permission to print your dream and experiment results in the future if it can be helpful or inspirational to others?

(a) Yes, using only my initials and city.

(b) Yes, anonymously.

(c) No.

Record the following information for each dream:

Incubation Goal (one sentence):

About the Related Dream

Date

Time you went to bed.

Time you recorded dream.

Dream Title

Content:

Your insights / interpretation about the dream (please be concise):

Related waking events (please be concise:)

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