First name Last name Date of initiation Regular practice Did you miss any meditation sessions this week? Yes No If yes, please indicate the reason for not meditating: Approximately how many meditation sessions have you missed this month? 1-3 3-5 6-10 11 or more If you miss a meditation session, when does it generally occur? Morning Evening Varies Correct practice How long do you meditate each time? Do you notice the mantra change in any way? Did you feel at times it became slower or faster, fainter, etc? Do you sometimes lose the mantra? Do you feel that time during the meditation passed quickly? Do many thoughts come? Do thoughts disturb you? Do you hear outer noises? Do you feel disturbed by outer noises? Do you at any moment find that you were unaware of body and surroundings? During meditation do you notice any change in your breathing? During meditation did you feel so relaxed as to feel sleepy? Possible effects/benefits After meditation do you feel inclined to rest or do you feel energetic? Have you noticed any indication of increasing clarity of mind? Have you noticed any improvement in your relationship with others? Has anyone remarked upon any change in you? How do you feel today as compared to before you learned Vedic Meditation? Do you now feel that you have understood how to meditate? Any other remarks?