Your Full Name:
Age:
Single or Taken:
Favorite Movie:
Favorite Song:
Kinky or Clean:
Do we know each other outside of bebo?
What song reminds you of me?
Would you keep a secret from me?
What is your favorite memory of us?
Tell me one odd/intresting fact about you?
Do you want to tell me something that you couldn't before?
If I were a sweet what would I be?
Whats ur best feature?
Do you think I'm a good person?
Do you think I'm attractive?
Would you come over for no reason just to hang out?
Will you post this so I can fill it out for you?

ADHD (attention deficit/hyperactivity disorder)

[] you are hyper most of the time.

[x] you barely pay attention to anything.

[] you cannot cooperate with people well.

[x] you seem to never sit still.

[] you talk all the time.

[] you need attention 24/7.

total: 2



Bipolar Disorder

[x] you can act wild at times then the next you are upset.

[x] you are very irritable.

[x] you get barely any or no sleep.

[] you are anti-social.

[] you have very high self esteem at times.

[x] you are abusing alcohol, drugs, or sex.

total: 4



Bulimia Nervosa

[] you throw up all of your food.

[] you throw it up even when you don't feel sick.

[x] you have no control over how you eat.

[] you use laxatives.

[] you've fasted.

[] you have overly excercised to where you almost fainted/passed out.

[] you always say you are fat, when you aren't.

] people think you are way too skinny.

total: 1



Conduct Disorder

[] you are a bully.

[x] you threaten other people.

[x] you often find yourself in fights.

[x] you have used a weapon that could cause injury to others. (ex: knife, bat, etc.)

[] you are cruel to humans and/or animals.

[] you have molested someone.

[x] you destroy property on purpose.

[] you always lie.

[] you stay out all night.

[] you have ran away from home.

total: 3



Depression

[x] you are always sad.

[x] you always are crying.

[x] you find no hope in your future.

[x] you find no longer excitement over the activities you used to love.

[x] you always find yourself around the house or in bed all day.

[x] you can be/are anti-social.

[x] you have low self esteem.

[x] everything bad that happens is always your fault.

[x] you always seem to be weak or have physical features hurt.

[x] you are failing school.

[] you have ran away from home.

[x] hope is no longer there for you.

total: 11



OCD (obsession compulsive disorder)

[] you have daily rituals.

[x] you have disturbing thoughts or thoughts you hate.

[x] you have to do a certain thing until it feels right.

[] you have to keep things in a certain order.

[x] you have harmed yourself.

[] you are afraid you will get any kind of germs.

[x] you have to check some stuff over again. (ex: checking door repeatly)

total: 4



PTSD (post-traumatic stress disorder)

[] you repeatly have flashbacks of horrible moments/memories in your life.

[x] you repeatly have dreams of horrible moments/memories in your life.

[x] you sometimes think the event will happen again.

[x] you feel highly uncomfortable when remembered/remembering the event.

[x] you can be/are anti-social.

[x] you have lost interest in the things you used to love.

[x] you have not had alot of sleep lately.

[] you worry about dying at a early age or dying at all.

[x] you can have angry outbursts.

[x...not thumbsucking.....] you act younger than your age. (ex: thumbsucking, etc.)

total: 8



Schizophrenia

[] you often have hallucinations

[x] you have strange, unusual dreams or thoughts.

[x] you can be confused about reality and fantasy.

[x] you think people are always staring or talking about you.

[] you have extreme anxiety or fearfullness.

[x] you have difficulty with relationships with family, friends, and opposite sex.

[] you do not take care of your hygeine like you should.

[] you are very shy.

[] you often talk to yourself.

total: 4

Deep down inside
There is a lonely girl that hides
She’s lost and scared and wants to come out
But can’t find her way
She was hidden in a dark dark, far away place
From the world purposely misplaced
She needs the light to leave her shame
Until the day she finds the light
She'll be lonely scared, lost inside