Name/Pseudonym:
Please indicate your sex: male female intersexed
Are you gifted? no not sure top ten percent 98th percentile (Mensa level) 99.9th percentile
Are you on the autistic spectrum? no not sure yes - formal diagnosis yes - self diagnosed
If yes, which diagnosis?
Here are a number of characteristics that may or may not apply to you. For example, do you agree that you are someone who likes to spend time with others?
Please write a number next to each statement to indicate the extent to which you agree or disagree with that statement.
I see myself as someone who . . .
If for some reason this form does not work for you, please copy it into an email (NO ATTACHMENTS PLEASE!) and email it to me at acerridwen@telus.net
Source: Lawrence A. Pervin and Oliver P. John , eds., 1999. Handbook of personality: Theory and research, second edition. Guilford Press, New York/London, page 132.