PRECLEAR: __________________________ AUDITOR: __________________________

Time period covered

This form, and others to be issued, are a breakdown of the 8 dynamics into areas where important itsa may be developed.

Date assessment started

Write down important information about your pc on data sheets with consecutively numbered pages. Also note down on the data sheet the number of the dynamic you are working on and the designation letter from this form of the area being covered. Keep a running recording of time and TA position on the left-hand margin of your data sheet.

1st Run: __________ __________

On the form record the TA position at the start and again at the end of working on any specific area and check off each area and sub area covered.

2nd Run: __________ __________

Also write down the data sheet page number on the form so that the information can be found easily if so required.

3rd Run: __________ __________

All other information should be recorded on the data sheets which are kept attached to the form.

This form can be used several times, each time taking up a longer period of this lifetime with the pc. It is suggested that the first time through you cover present time back to about a year ago, the second time you cover a longer period (say about the past 10 years) and the third time through cover this lifetime. This will of course vary from pc to pc.

Some areas on this form will develop a tremendous amount of itsa, others very little. Work at the pc reality level and where the pc’s interest lies. Don’t be in a hurry to leave an area if the pc has a good itsa line going and you are getting good TA action. Clean up any hot area thoroughly before leaving it. However if an area has nothing in it don’t spend a lot of time with it. Get on down the line to something that produces itsa and TA action.

1. Pc’s full name.

If you or the pc don’t understand any of the form’s areas of potential itsa, skip them. However, don’t skip something because you think the pc has nothing on it or you are afraid of being “nosy.”

2. Other names pc has used.

No attempt has been made to give you the questions to ask and some of the form’s sub areas would not pertain to a short time period. Use the sub areas that pertain to the time period you are handling or shift them around to fit your time period. Some sub areas are much more important than others, but this will depend on your pc. Add into the space provided anything else you find to be important.

3. Names pc has been called or given.

In getting in the itsa line on any area and sub area on this assessment be very sure to cover the following points:

4. Name pc prefers.

1. Where it is or was, and its location relative to other locations.

5. Names pc would rather have and rather not have.

2. Who are the people involved.

6. Titles and degrees.

3. When it was, and how long did it take place.

7. (Other)

The stress of this assessment is not in finding something. The stress is on TA motion. At the end of the session add up the total amount of TA blowdown only (that’s downward movement, 4 to 3, 5.5 to 3.75). If your total downward TA movement is 30 divisions of TA or more you can consider that you have had good TA motion. If your total is 40 divisions or more, you have had excellent TA motion. If you have less than 20 divisions of downward TA motion, one of two things are wrong. The first is that you are not letting the pc itsa and you don’t have a clue about what itsa is.

1. Current major position.

The second is that the pc has a this lifetime ARC break of fantastic magnitude. If this is the case you should handle it as follows.

2. Other current positions and titles.

3. Positions pc would like to have.

1. Make a short list of major this lifetime ARC breaks.

4. Positions pc would rather not have.

2. Assess the list for the major ARC break.

5. Past history of the above.

3. Date the ARC break.

6. (Other)

4. Take the period a month or so before and after the ARC break and run R2H on this time period.

5. Continue with R2C Slow Assessment.

1. What pc is mainly being.

2. What pc would rather be.

Study these directions and know them perfectly before you audit with the form. It is essential that you keep all records of R2C legibly and exact. The data is vital for later running of the whole track.

3. What pc would rather not be.

4. What pc has mainly been.

5. Would rather not have been.

6. Would rather have been.

7. Other identities pc has been and is being.

8. (Other)

1. Education level attained.

2. Recent courses or training.

3. The importance of education.

4. Past education/training.

5. Early education/training.

6. Self-education.

7. (Other)

1. Current job or work.

2. Other earning capacity.

3. What receives by working.

4. Area of influence.

5. Responsibilities.

6. (Other)

1. Hobbies.

2. Other interests.

3. Skills.

4. Major skill.

5. Unusual interests.

6. Future interests.

7. Past interests, hobbies and skills.

8. (Other)

1. Things pc feels compelled to do.

2. Must prevent himself from doing.

3. Fears.

4. Bad habits.

5. Other habits.

6. Unusual precautions.

7. (Other)

1. What pc mainly does.

2. What pc would rather do.

3. What pc would rather not do.

4. Has mainly done in past.

5. Would rather not have done.

6. Would rather have done.

7. Other things pc is doing and has done.

8. Pc’s activity level.

9. Pc’s necessity level.

10. (Other)

1. Genetic line.

2. Body condition.

3. Body defects.

4. Exercise.

5. Body care.

6. Eating and diet.

7. Accidents.

8. Illness.

9. Medications.

10. Drugs.

11. Medical care.

12. Glasses.

13. Artificial body parts.

14. Relationship to body.

15. ARC with body.

16. Birth.

17. Death.

18. (Other)

1. Where living.

2. Where working.

3. Where normally visits.

4. Where friends live.

5. Where goes for recreation.

6. Area of everyday environment.

7. Area of monthly environment.

8. Area of yearly environment.

9. Area of this life environment.

10. Birth place.

11. Location of definition of past areas of residence and activity.

12. (Other)

1. Appointments.

2. Has enough time.

3. Has too much time.

4. Has not enough time.

5. Is too young.

6. Is too old.

7. Is too fast.

8. Is too slow.

9. (Other)

1. Personal effects.

2. Clothes.

3. Machines.

4. Books.

5. Money.

6. Property.

7. Business interests.

8. Stocks and bonds.

9. Public property.

10. Cities and countryside.

11. Other people’s property.

12. Saves things.

13. Wastes things.

14. Destroys things.

15. Creates things.

16. Handling and control of other dynamics.

17. Handling and control of MEST.

18. (Other)

1. What pc mainly has.

2. What pc would rather have.

3. What pc would rather not have.

4. Has mainly had in the past.

5. Would rather not have had.

6. Would rather have had.

7. Other things pc has and has had.

8. Pc’s ability to have.

9. (Other)

1. Mental condition.

2. Mental defects.

3. Medical/psychiatric treatment.

4. Electric shock.

5. Brain surgery.

6. Treatment with drugs.

7. Psychoanalysis.

8. Mystical or occult exercises.

9. Hypnotism.

10. Self-analysis.

11. Self-auditing.

12. Squirrel auditing.

13. Psychology.

14. Other mental treatment.

15. (Other)

1. Current auditing.

2. Recent auditors.

3. Processes run.

4. Recent auditing gains.

5. Recent auditing loses.

6. Present processing goals.

7. Past auditing history.

8. (Other)

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________

7. __________

8. __________

9. __________

10. __________

1. Relationship with father.

2. Relationship with mother.

3. Relationship with foster parents or other guardians.

4. Who pc considers to be closest to acting as parents.

5. (Other)

1. Brothers.

2. Sisters.

3. Aunts and uncles.

4. Grandparents.

5. Cousins.

6. Other relatives.

7. (Other)

1. Wife or husband.

2. Children.

3. Spouse’s family.

4. Other wives or husbands.

5. Children by someone other than spouse.

6. (Other)

1. Sex with spouse.

2. Extramarital relations.

3. Premarital relations.

4. Sex with opposite sex.

5. Past history of above.

6. (Other)

1. Types of sex.

2. Homosexuality.

3. Sex with animals.

4. Fetishes.

5. Sex with children.

6. Unusual sex.

7. Absence of sex.

8. Substitutions for sex.

9. Masturbation.

10. Areas related to sex.

11. (Other)

1. Procreation.

2. Contraception.

3. Sex for pleasure.

4. Babies.

5. Childbearing.

6. Pregnancy.

7. Abortion.

8. Miscarriage.

9. Family planning.

10. Family survival.

11. (Other)

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________

7. __________

8. __________

9. __________

10. __________

1. Close friends.

2. Old friends.

3. Other friends.

4. Acquaintances.

5. Unwanted friends.

6. Wanted friends.

7. Friendship.

8. Allies.

9. Sympathies.

10. Us.

11. (Other)

1. Strong enemies.

2. People pc dislikes.

3. People who dislike pc.

4. ARC breaks.

5. Opposition groups.

6. Opposition force.

7. Them.

8. (Other)

1. Job or work.

2. Clubs.

3. Organizations.

4. Common purposes.

5. Social groups.

6. Activity with others.

7. Support of others.

8. Other groups.

9. Dues and financial support.

10. Contributions.

11. Benefits.

12. Codes and rules.

13. Membership.

14. (Other)

1. Local government.

2. Regional government.

3. National government.

4. Nationality.

5. Foreigners.

6. Politics.

7. Elections.

8. Government leadership.

9. Types of government.

10. Taxes.

11. Laws.

12. Courts.

13. National boundaries.

14. Government ownership.

15. Government workers.

16. Government control.

17. (Other)

1. Social conduct.

2. Codes.

3. Right and wrong.

4. Law enforcement.

5. Law breaking.

6. Criminal activities.

7. Criminal record.

8. Contributions.

9. Benefits.

10. Classes.

11. Public ownership.

12. Public servants.

13. (Other)

1. Pc’s race.

2. Other races.

3. Racial differences.

4. Racial similarities.

5. Color.

6. Racial land areas.

7. Unusual peoples.

8. (Other)

1. Work.

2. Social.

3. Recreation.

4. Other areas.

5. Responsibility for others.

6. Good leadership.

7. Bad leadership.

8. Control.

9. Followers.

10. (Other)

1. Auditing.

2. Co-auditing.

3. Group auditing.

4. Missions.

5. Field groups.

6. Central Orgs.

7. HCO.

8. Courses.

9. Dissemination.

10. L. Ron Hubbard.

11. Saint Hill.

12. (Other)

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________

7. __________

8. __________

9. __________

10. __________

1. Communication between countries.

2. War.

3. Peace.

4. World government.

5. International trade.

6. Languages.

7. Tourists.

8. World business.

9. Treaties.

10. International law.

11. (Other)

1. Intelligent life on other planets.

2. Marcab Federation.

3. Galactic Federation.

4. Space travel.

5. Flying saucers.

6. Position of Earth to the universe.

7. (Other)

1. Radio and TV.

2. Newspapers.

3. Books.

4. Art.

5. Cinema.

6. Theater.

7. Entertainment.

8. (Other)

1. The role of mankind.

2. Survival of the species.

3. Overpopulation.

4. Underpopulation.

5. The new man.

6. (Other)

1. World dissemination.

2. Scientology publications.

3. Scientology One.

4. Psychotherapy.

5. World clearing.

6. Scientology future.

7. The role of Scientology.

8. Scientology success.

9. Scientology failure.

10. Scientology growth.

11. Mental healing methods.

12. The public image.

13. The future of mankind.

14. Healing.

15. Clearing.

16. Operating Thetans.

17. Scientology influence and control.

18. (Other)

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________

7. __________

8. __________

9. __________

10. __________