Bold what applies to you:
Appearance
- I have/had piercings besides the ears.
- I want piercings besides the ears.
- I have a scar.
- I tan easily.
- I wish my hair was a different color.
- I have friends who have never seen my natural hair color.
- I have/want a tattoo.
- I can be self-conscious about my appearance.
- I have/had braces.
- I have more than two piercings.
Embarrassment
- Disney movies still make me cry sometimes.
- I’ve laughed so hard I’ve cried.
- I’ve glued my hand to something.
- I’ve laughed until some kind of beverage came out of my nose.
- I’ve had my pants rip in public.
- I’ve touched something sharp/hot/etc to see if it would hurt.
Health
- I’ve gotten stitches.
- I’ve broken or dislocated a bone.
- I’ve had my tonsils removed.
- I’ve had my wisdom teeth removed.
- I’ve had chicken pox.
Travel
- I’ve been to Florida.
- I’ve driven/ridden over 200 kilometres in one day.
- I’ve been on a plane.
- I’ve been to California.
- I’ve been to Asia.
- I’ve been to Africa
- I’ve been to Niagara Falls.
- I’ve been to Vanuatu or the Mystery Islands.
- I’ve been to the Caribbean.
- I’ve been to Europe.
Experiences
- I’ve gotten lost in my city.
- I’ve seen a shooting star.
- I’ve wished on a shooting star.
- I’ve seen a meteor shower.
- I’ve gone out in public in my pajamas.
- I’ve pushed all the buttons on an elevator.
- I’ve slapped someone.
- I’ve kissed someone underwater.
- I’ve hugged something.
- I’ve crashed a car.
- I’ve been skiing.
- I’ve been in a musical.
- I’ve auditioned for something.
- I’ve been on stage.
- I’ve caught a snowflake on my tongue.
- I’ve sat on a rooftop at night.
- I’ve pranked someone.
- I’ve ridden in a taxi.
Death
- I’m afraid of dying.
- I hate funerals.
- I’ve seen someone/something die.
- Someone close to me has attempted/committed suicide.
- I have attempted suicide.
- I’ve thought about suicide before.
- I’ve written a eulogy for myself.
Bad times
- I regularly drink.
- I can’t swallow pills.
- I can swallow numerous pills at a time without difficulty.
- I’ve been diagnosed with depression at some point.
- I have/had anxiety problems.
- I shut others out when I’m upset.
- I don’t have anyone to talk to when I’m upset about something personal.
- I have taken/take anti-depressants.
- I’ve slept an entire day before.
- I’ve plotted revenge.



