Total: 0%

HAVE YOU BROKEN OR DISLOCATED:
[ ] Your arm
[ ] Your leg
[ ] You shoulder
[ ] Your hip
[ ] Your knee
[ ] A finger(s)
[ ] Toes
[ ] Back
[ ] Had a hard time because of them
[ ] Had someone leave because of them.

Total: 0

HAVE YOU EVER:
[x] Had your heart broken
[] Had someone close to you die
[] Had to hurt someone you loved
[x] Wanted to hurt someone you loved
[x] Hurt someone else for someone you loved
[x] Broken down
[x] Been betrayed
[x] Betrayed someone
[x] Been afraid to ask for help
[] Asked for help, but was turned away

[x] Lied to hurt someone
[x] Lied to protect someone
[x] Lied to a friend
[] Lied to a lover
[x] Lied to an enemy
[x] Felt unbelievably guilty
[x] Had that guilt trouble you for a long time
[x] Accidentally caused someone injury
[x] Caused someone you love injury
[] Caused someone you love's death.
Total: 15

HOW MANY SCARS DO YOU HAVE? (Check off each one that applies)
[x] 1 or 2
[x] 5 or so
[x] 10 or so
[x] 15 or so
[x] at least 25
[] at least 40
[] 40-60
[] 60-80
[] 80-100
[] More then 100
Total: 20

HAVE YOU:
[x] Hit something out of anger
[x] Hit someone out of anger
[x] Hit something to cause yourself pain
[x] Hit something to cause yourself pain to distract from other pain
[x] Cut yourself once, to try
[x] Cut yourself more then once
[] Pierced anything to distract you
[] Pierced several things to distract you
[] Closed yourself off with a series or book to distract yourself
[] Closed yourself off for days on end to distract yourself.
Total: 26

HAS ANYONE:
[x] Laughed at you
[x] Abandoned you
[x] Turned their back on you
[x] Ignored you
[x] Stabbed you in the back
[x] Been two faced with you
[x] Intentionally hurt you
[x] Left you for someone else
[x] Used you
[x] Used you then ditched you
Total: 36

HAVE YOU:
[x] Used someone
[] Used someone then ditched them
[x] Abandoned someone
[x] Turned your back on someone
[x] Turned your back on someone who was depending on you
[] Left someone for another person
[] Pushed someone away
[] Pushed them away out of fear
[] Pushed them away out of anger
[] Pushed them away 'for their own good'.

Total: 40

HAVE YOU:
[x] Tried to change yourself for someone else
[] Unsuccessfully
[x] Had someone push you away
[x] Because they thought it would be better for you
[x] Fallen for someone who didn't return the feelings.
[x] Been jealous of someone
[x] Pined over someone
[x] For more then a year
[] For more then 5 years
[x] Fallen for someone who 'couldn't' return the feelings.
Total: 48

ARE YOU:
[x] Ever depressed
[x] For more then a week
[x] More then a month
[] Miserable, consistantly
[x] Afraid of commitment
[x] Worried about the future
[x] Apathetic
[] Nostalgic
[x] Broken (In your opinion)
[x] Unfixable (In your opinion)
Total: 56

DO YOU:
[x] Think about your past
[] Longingly
[x] Wish you could change something you've done
[x] Wish you could change something big you've done
[x] Obsess
[x] Obsess about people
[] Obsess to escape
[x] Get lost in your imagination
[] Fantasize about your life being different
[] Truly wish it WAS different

Total= 62% damaged.