Section A: Please select all that apply:
- I have been to the bathroom recently
- I have not been to the bathroom recently
- I have forgotten what the bathroom is
Section B: Please answer the following questions in as much detail as possible:
- Please list all the ways in which you have failed today
- Please describe your feelings about the meaninglessness of existence
- Please provide a detailed account of your favorite food item
Section C: Please sign and date the following: