2. Gender
*
Male
Female
Non-binary
Prefer not to say
Other
3. Do you regularly engage in any reflective or contemplative practices? (e.g., meditation, time in nature, artistic expression, journaling)
*
Yes
No
Occasionally
4. Have you ever had an experience where you felt a deep connection with something beyond yourself, such as an animal, plant, or natural object (e.g., a stone, a river, the wind)?
*
Yes
No
Unsure
Section 2: Experience Recognition
1. Feeling the texture of tree bark beneath your fingertips. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
2. Sensing a profound stillness while sitting beside a river. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
3. Feeling deeply moved by the eyes of an animal. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
4. Noticing the warmth of the sun on your face. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
5. Having a sense that a particular stone holds meaning or energy for you. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
6. Smelling fresh earth after rain and feeling grounded. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
7. Experiencing an unspoken understanding with an animal. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
8. Holding a piece of clay or a rock and sensing something beyond its physical form. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
9. Feeling an unexpected connection to a tree, as if it has presence or wisdom. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
10. Hearing the sound of the wind and experiencing a shift in awareness. (1-5)
*
For each statement, indicate how you would classify the experience described.
(Scale: 1 = Physical Sensation, 2 = Mostly Physical, 3 = Both, 4 = Mostly Deep Connection, 5 =
Deep Connection)
1 (Physical Sensation)
2 (Mostly Physical Sensation)
3 (Both)
4 (Mostly Deep Connection)
5 (Deep Connection)
Section 3: Personal Reflections
1. Can you describe a time when you felt a connection to an animal, plant, or natural object in a way that was meaningful to you?
*
2. How do you personally distinguish between a physical experience and a deeper connection with something?
*
3. Do you think there is a difference between sensing something physically and sensing its essence? Why or why not?
*
2. Do you think developing a deeper awareness of these experiences could enhance your understanding of life?
*
Yes
No
Unsure
3. Would you be interested in exploring practices that help deepen your connection to the natural world?
*
Yes
No
Contact Information
Your Name
*
First Name
Last Name
Your Email
*