Purification Rundown Delivery Manual PDF

DELIVERY MANUAL
DELIVERY MANUAL
B A S E D O N THE WORKS O F
A HUBBARD PUBLICATION
Bridge Publications, Inc. 4751 Fountain Avenue
Los Angeles, California 90029 ISBN 0-88404-568-4

NEW ERA Publications International, ApS Store Kongensgade 55 1264 Copenhagen K, Denmark ISBN 87-7336-727-3
1990 L. Ron Hubbard Library All Rights Reserved
No part of this book may be reproduced without the permission of the copyright owner. This manual is based on the works of L. Ron Hubbard, who developed Scientology applied religious philosophy. It is presented to the reader as a record of observations and research into the nature of the human mind and spirit, and not as a statement of claims made by the author. The benefits and goals of Scientology can be attained only by the dedicated efforts of the reader.
The Purification Rundown is a religious service delivered by the Church of Scientology. It is not professed as a physical handling for bodies nor is any claim made to that effect. There are no medical recommendations or claims
for the Purification Rundown.

No individual should undertake the Purification Rundown or any of its regimens without first consulting and obtaining the informed approval of a licensed medical practitioner. The author makes no warranties or representation as to the effectiveness of the Purification Rundown. Purification, Purification Rundown and Purif are trademarks for the detoxification program covered in this manual and are used as such in the writings of L. Ron Hubbard. They are registered as service marks and are owned by Religious Technology Center. These marks may not be used as designations for the detoxification program given in this work without the prior consent of Religious Technology Center.
Hubbard, Scientology, E-Meter, Flag, Freewinds, Celebrity Center and Golden Era Productions are trademarks and service marks owned by Religious Technology Center and
are used with its permission.
Bridge Publications, Inc. is a registered trademark and service mark and it is owned by Bridge Publications, Inc. NEW ERA is a trademark and service mark.
Printed in the United States of America
WARNING
This program can be strenuous and should not be undertaken by anyone who has a weak heart or who is anemic. It is therefore absolutely essential that the following rules are strictly adhered to: 1. No one may begin the Purification Rundown without first obtaining the written approval from a qualified medical doctor. 2. No one with a weak heart or who is anemic may do the Purification Rundown. These points must be checked as part of the medical doctor's examination for approval to begin the rundown. 3. People with known heart conditions, high blood pressure, anemia and certain kidney conditions may do a much less strenuous program of exercise and nutrition (as worked out for them with a medical doctor) but may not do the Purification Rundown. 4. Blood pressure checks and checks for anemia are given periodically as the person goes through the program and if any signs of a weak heart or anemia should appear, the person is taken off the rundown and handled medically.
IMPORTANT NOTE
In reading this book, be very certain you never go past a word you do not fully understand. The only reason a person gives up a study or becomes confused or unable to learn is because he or she has gone past a word that was not understood. The confusion or inability to grasp or learn comes AFTER a word that the person did not have defined and understood. Have you ever had the experience of coming to the end of a page and realizing you didn't know what you had read? Well, somewhere earlier on that page you went past a word that you had no definition for or an incorrect definition for. Here's an example. "It was found that when the crepuscule arrived the children were quieter and when it was not present , they were much livelier." You see what happens. You think you don't understand the whole idea, but the inability to understand came entirely from the one word you could not define, crepuscule, which means twilight or darkness. It may not only be the new and unusual words that you will have to look up. Some commonly used words can often be misdefined and so cause confusion. This datum about not going past an undefined word is the most important fact in the whole subject of study. Every subject you have taken up and abandoned had its words which you failed to get defined. Therefore, in studying this book be very, very certain you never go past a word you do not fully understand . If the material becomes confusing or you can't seem to grasp it, there will be a word just earlier that you have not understood. Don't go any further, but go back to BEFORE you got into trouble, find the misunderstood word and get it defined.
A DOCTOR'S EVALUATION OF THE PURIFICATION PROGRAM

by Gene Denk Bachelor of Science, Doctor of Medicine
"An Evaluation of a Detoxification Program for Long-Term Stored Chemicals" is the title of a paper first published in 1981 and then appearing in Medical Hypothesis September 1982 by myself in concert with two colleagues: Megan Shields, M.D. and Steven Burton, M.D. This paper was the result of extensive study and testing of the Purification program developed by L. Ron Hubbard. The following are excerpts from the publication outlining some of our findings:
The purpose of this current study is to evaluate and document clinically observed physical or psychological changes that occur upon conclusion of the Purification program. In addition to clinical evaluations, psychological tests and standard blood chemistry were performed.
One hundred and three volunteers were selected to represent varying degrees of drug usage. California guidelines for human experimentation were followed, and informed consent obtained from all participants. Volunteers were accepted on a first application received basis, covering the spectrum from heavy (i.e., frequent heroin usage, hallucinogenics, frequent or severe use of medical drugs) to no drug usage. Most of the participants were from the Hollywood population at large and twenty were from Narconon Los Angeles, a local drug rehabilitation center. The volunteers were interviewed and demographic data (statistical data showing average age, income, education, etc.) was collected. This data was used to ensure a cross-section of drug users and of the general population were included in the study. A large variety of incidents occurred as individuals progressed through the program which were suggestive of drugs or chemicals being released from the body. There were reports of brief, full-blown "LSD trips" with hallucinations; some participants who had had ether (a colorless, sweet-smelling liquid used as an anesthetic) would smell like ether in the sauna; old injuries would flare up with swelling or redness along surgery lines and then resolve over a few days. The flushing that followed ingestion of niacin frequently would occur along lines of bathing suits or old sunburns; this would diminish over a few days
then reoccur in a different pattern. It was not unusual to have a person reexperience the physical condition associated with taking a certain drug or anesthetic. For instance, one patient complained of onset of mild pain in the lower right quarter of the body, nausea, light-headedness and reddening of an old appendix scar line. This reoccurred the next two days at lessening severity and then was gone in three days. The program appears safe as long as done under the care of a physician. The exercise and sauna are tolerated very well as long as they are begun on a gradient. As with any major physical exercise program, however, general physical condition and physical health need to be monitored. The authors feel this program is unadvisable for any person with heart disease or any other major physical disabilities unless directly done under the supervision of a physician who is willing to work out a specific exercise, sauna and vitamin program for the patient. Since the first publication of the above findings, tens of thousands of people have successfully undergone the Purification program, and the theories presented in this book are gaining increasing acceptance among medical doctors and scientists. Dr. Denk graduated Bachelor of Science from University of Michigan and Doctor of Medicine at University of Washington at Seattle. He maintains a private practice in Los Angeles.
PURIFICATION RUNDOWN PURPOSE

The purpose of the Purification Rundown is to clean out and purify one's system of all the accumulated impurities such as drugs, insecticides and pesticides, food preservatives, etc., etc., which by their presence and restimulative effects could prevent or delay freeing the being spiritually through processing.
PURPOSE OF THE PURIFICATION RUNDOWN DELIVERY MANUAL

This booklet exists and is used to ensure that a person receiving a Purification Rundown is actually receiving a correct and properly administered service. The Purification Rundown consists of very exact steps and procedures, and it is the responsibility of those delivering it and those receiving it to ensure that these steps and procedures are followed to the letter. It is very much to your benefit to see that this is done. If you are not being delivered a standard Purification Rundown as outlined in this manual, then it is your responsibility as a participant to report this to the Religious Technology Center, the proprietor of the service marks under which the rundown is delivered. Tear-out report sheets are provided in the booklet for this purpose.
DIRECTIONS
This manual is for your use to ensure that you receive a correct and properly administered Purification Rundown. It is kept in your own possession throughout your duration on the rundown. This manual, if followed, will take you all the way through the Purification Rundown. The manual consists of: (a) a checklist of actions to get you started on the rundown; (b) release waivers for you to sign; (c) a medical report form for your doctor to complete; (d) daily report forms; (e) forms for writing up any gains or improvements made during the rundown, called "Success Story" forms; (f) forms which you can use to get help within the organization if you are unhappy with your progress or the service you are receiving; and (g) forms to report nonstandard delivery (as mentioned earlier in this booklet, under "PURPOSE").
To use this manual:

1. Complete the "Checklist for Starting the Purification Rundown" (which follows these directions) with the Purification Rundown in-Charge.
2. Proceed page by page through the booklet, filling out your daily report forms as you progress on the rundown.
3. As each daily report form is completed, tear it out and give it to the Purification Rundown In-Charge who oversees your progress on the program on a day-to-day basis. (If doing the rundown in a Scientology church or mission, you must do the rundown right there in the organization and may not do the rundown in a location remote from where the Purif I/C can supervise you directly.) 4. The Purif I/C will then fill in his portion of the form and send it on to the Case Supervisor in your Purification Rundown folder.
Each person doing the rundown must obtain his own copy of this manual before starting, and use it as he progresses through to completion of the rundown. Proper use of the booklet is a key action in ensuring maximum results are obtained.
CHECKLIST FOR STARTING THE PURIFICATION RUNDOWN

NAME DATE
Welcome to the Purification Rundown.

The Purification In-Charge (Purif I/C) will see to it that you: a. have been properly enrolled for the rundown, including proper financial arrangements and invoicing, and will ensure that you have your own personal copies of this delivery manual, Purification: An illustrated Answer to Drugs, All About Radiation and Clear Body, Clear Mind: The Effective Purification Program; Purif I/C
b. are interviewed with regard to drugs and medicines you have taken, or any toxic substances or radiation you may have been exposed to; Purif I/C c. sign the Release of Liability, Indemnity Agreement and Contract, and sign the Medical Declaration for Participation in Purification Rundown both of which follow this checklist (these do not replace the Enrollment Agreement signed earlier at the Registrar);
Purif I/C d. see a qualified medical doctor to give you a physical examination in order to determine if you can do the Purification Rundown and have him complete the Medical Report which appears in the following pages; Purif I/C
e. take tests (Oxford Capacity Analysis, which is a personality test, plus an IQ test and an Aptitude test);
Purif I/C
f. read the Purpose of the Purification Rundown and the Purpose and Directions of this manual and have had any questions about the rundown or your use of this manual cleared up;
Purif I/C
g. set a regular schedule for doing the rundown. (Note: This schedule will be subject to Case Supervisor approval.) Purif I/C
The Purif I/C will assign you a twin. Your twin is your partner in doing the rundown, as described in the picture book. TWIN'S NAME Once all of the above steps have been done and the medical doctor has stated that it is okay for you to undertake this program, then you will be starting the rundown.
The Purif I/C will ensure that your tests, medical report, etc., are sent to your Case Supervisor and that he is notified that you're ready to begin.
Purif I/C: When all of the above steps (a) to (g) have been done, and the person has been assigned a twin, tear out this checklist, attach the person's schedule, routing form, interview worksheets, test results, and Medical Report form and send to the C/S in the person's Purification Rundown folder. The signed release waivers are torn out and routed to the Director of Inspections and Reports for filing in Valuable Documents.
(If this person is going to be receiving auditing on Objective Processes while on the rundown, you must also ensure that he understands how this will be scheduled and run.)
RELEASE OF LIABILITY, INDEMNITY AGREEMENT AND CONTRACT

I, , HEREBY ACKNOWLEDGE that I have voluntarily applied to participate in a RELIGIOUS SERVICE , known as the Purification Rundown", concerned with freeing up the individual spiritually from the traumatic or disruptive effects of drugs and toxins on the spirit. I UNDERSTAND THAT THE PURIFICATION RUNDOWN IS DESIGNED TO GIVE SPIRITUAL AID, IS NOT MEDICAL TREATMENT NOR IS IT DESIGNED TO PROVIDE ANY PHYSICAL GAINS. PLEASE INITIAL I AM AWARE THAT THE PURIFICATION RUNDOWN ACTIVITIES CONSIST OF RUNNING OR OTHER STRENUOUS ACTIVITY TO PROMOTE CIRCULATION, PROLONGED PERIODS IN A SAUNA TO PROMOTE SWEATING, AND SUGGESTED QUANTITIES OF VITAMINS, MINERALS, AND OILS. PLEASE INITIAL I AM ALSO AWARE THAT I SHOULD NOT PARTICIPATE IN THE PURIFICATION RUNDOWN IF I HAVE A WEAK HEART, HIGH BLOOD PRESSURE, ANEMIA, LIVER DISEASE, DIABETES, OR OTHER CONDITIONS WHICH WOULD MAKE THE PURIFICATION RUNDOWN ACTIVITIES PARTICULARLY HAZARDOUS TO ME. PLEASE INITIAL ACKNOWLEDGING MY AWARENESS AND UNDERSTANDING OF THE ABOVE INITIALED PARAGRAPHS, I AM VOLUNTARILY PARTICIPATING IN THE PURIFICATION RUNDOWN ACTIVITIES WITH KNOWLEDGE OF THE POTENTIAL DANGER INVOLVED AND HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY, LOSS, OR DAMAGE. PLEASE INITIAL AS CONSIDERATION for being permitted by the Church of Scientology of , (hereinafter referred to as "the Church") to participate in the Purification Rundown and use its facilities and other facilities provided for such purpose, I HEREBY AGREE THAT I, MY HEIRS , DISTRIBUTEES , GUARDIANS, LEGAL REPRESENTATIVES AND ASSIGNS WILL NOT MAKE CLAIM AGAINST, SUE, ATTACK THE PROPERTY OF, OR PROSECUTE the Church,Religious Technology Center, Church of Scientology International, and/or one of its affiliated Churches, Missions,
corporations, associations, partnerships or organizations, and/or their agents, servants, successors, heirs, executors, or representatives, and/or the owners, managers, employees, agents or representatives of or associated with any facilities conducting the Purification Rundown (hereinafter collectively referred to as "the Releasees") for injury or damage resulting from the negligence or other acts, howsoever caused, by any Releasee or by any employee, agent or contractor of the Church, its affiliates, or other Releasee, in any way relating to my participation in the Purification Rundown.
IN ADDITION , I HEREBY RELEASE AND DISCHARGE THE RELEASEES from all actions, claims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter have for injury or damage resulting from my participation in the Purification Rundown . I FURTHER AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES and each of them from any loss, liability, damage or cost they may incur due to my participation in the Purification Rundown and/or due to my presence or action in or about the Church premises or the facilities provided for the Purification Rundown and whether caused by the negligence of the Releasees or otherwise. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, INDEMNITY AGREEMENT AND A CONTRACT BETWEEN MYSELF AND THE CHURCH AND/OR ITS AFFILIATED ORGANIZATIONS, AND/OR OTHER INDIVIDUALS, AND UNDERSTAND AND AGREE THAT THIS RELEASE CONTRACT SHALL BE GOVERNED EXCLUSIVELY BY THE LAWS OF THIS JURISDICTION, AND SIGN IT OF MY OWN FREE WILL, ON THIS DAY OF , 20
SIGNATURE ( Participant) (Signature of Parent or Guardian if Minor)
(Printed Full Name)
(Home Street Address) Witness Signature Date
(City and State /Country)
Sc,,- opy and PwifKalion Rundown a, i.a.kma,As and -- ma.k, or R,'*ous Tech-lo,,, f enoi and ae uwd with ita Ite .n,ssion Printed n the US
MEDICAL DECLARATION FOR PARTICIPATION IN PURIFICATION RUNDOWNTM

I, DECLARE AS FOLLOWS: 1) 1 understand that the Purification Rundown is a RELIGIOUS SERVICE concerned with freeing up the individual spiritually from the traumatic or disruptive effects of drugs and toxins to the spirit; and is not intended to treat, diagnose or cure physical illness or conditions, and that it is not for the purpose of handling or treatment of any physical or bodily ill or condition I may now have or may at any time in the future develop, or become aware of, such being the sole responsibility of myself and my physician. 2) I understand that the Purification Rundown is designed to give SPIRITUAL AID , is not medical treatment nor is it designed to provide any physical gains. 3) I represent that I am in good physical health, that I am neither pregnant nor have any suspected or confirmed heart ailments whatsoever, that I am not now taking any medication, and that I am fully aware that the Purification Rundown will be physically strenuous. 4) I further understand that no employee, agent or staff member of the Church of Scientology" of (hereinafter referred to as "the Church") is authorized by the Church to prescribe for or treat any physical ailments, and that no representations or promises as to physical benefits, gains, or results have been made by any employee, agent or staff member of the Church. 5) I hereby represent that prior to starting the Purification Rundown I provided a licensed medical practitioner (i) all the details of the Purification Rundown in all particulars, including the requirement that no person with a weak heart, high blood pressure, anemia, liver disease, or other hazardous conditions may take the program and (ii) a truthful and complete medical history, and I did receive from that practitioner written approval to do the rundown based on his/her assessment that doing the rundown would in no way endanger or otherwise pose any liability to my physical health and wellbeing. 6) I agree that I will seek blood pressure checks and checks for anemia periodically during the Purification Rundown and if any signs of a weak heart or anemia appear, I must stop further participation and will seek the
diagnosis of and will rely on my medical doctor for evaluation and resolution of the condition. 7) I have freely and voluntarily decided to participate in the Purification Rundown after having been apprised of all information relevant to it, and after having been given a complete opportunity to make inquiry both inside and outside the Church to obtain any additional facts, opinion or law which may possibly bear on my decision to participate in the Purification Rundown. 8) 1 further understand that the Church has relied on my statements contained in this declaration and in the "Release of Liability, Indemnity Agreement and Contract"-also, read, understood and signed by me-in accepting my application to participate in the Purification Rundown. 9) I am signing this declaration after having read and understood it; in signing it I have not relied on any inducements, promises, or representations made by the Church; and understand and agree that this declaration shall be governed exclusively by the laws of this jurisdiction.
I DECLARE under penalty of perjury under the laws of the

(country and state/province) that the foregoing is true and correct and binding on myself, my heirs, executors, administrators, successors and assigns. Executed this day of 20 at
(City) (State/Province and Country)
(Signature) Witness Signature Date
(Signature of Parent or Guardian if a Minor)
Yimmlogy n4 P.4-1- RuSoxp are -4rmarks ai i -.- masks d RelrRio^^s irrhno'ogv C- -d a'e ucn wnh A permnsion Mnn.f ., the US
MEDICAL REPORT
CONFIDENTIAL
TO THE APPLICANT
, hereby give my consent

NAME OF PATIENT to
to fill out the form below
DOCTOR'S NAME giving the details of my present physical condition in connection with my participation in the Purification Rundown at the Church of Scientology of
I agree to be responsible for payment of the doctor's fee for this service.
TO THE ATTENDING DOCTOR Please fill out the form below and return it to the applicant. The contents will be treated in the utmost confidence. NAME OF PATIENT: HIS/HER DATE OF BIRTH: 1. BLOOD PRESSURE : SYSTOLIC DIASTOLIC 1A. ARE THERE ANY SIGNS OF: ANEMIA Yes No WEAK HEART Yes No LIVER DISEASE Yes No DIABETES Yes No If the answer is yes to any of the above, please specify the relevant details below.
I B. ARE THERE ANY VITAMIN DEFICIENCIES: Yes No
If yes, please specify the relevant details below.
2. HEIGHT: 3. WEIGHT:
4. GENERAL APPEARANCE: 5. ANY EVIDENCE OF CARDIOVASCULAR DISEASE: Yes No If yes, please specify the relevant details on the reverse side of this form. 6. ANY EVIDENCE OF KIDNEY DISEASE: Yes No If yes, please specify the relevant details on the reverse side of this form. 7. GIVEN THAT THE ABOVE NAMED PATIENT INTENDS TO PARTICIPATE IN A RELIGIOUS SERVICE KNOWN AS THE PURIFICATION RUNDOWN, WHICH INCLUDES RUNNING OR OTHER STRENUOUS ACTIVITY TO PROMOTE CIRCULATION, PROLONGED PERIODS IN A SAUNA AT TEMPERATURES RANGING FROM TO TO PROMOTE PERSPIRATION, AND SUGGESTED QUANTITIES OF VITAMINS, MINERALS AND OILS, ARE THERE ANY REASONS WHY IN YOUR OPINION SAID PATIENT SHOULD NOT PARTICIPATE IN THE PURIFICATION RUNDOWN AS DESCRIBED? YES NO 8. ANY SPECIAL RECOMMENDATIONS:
9. ANY SPECIAL PRECAUTIONS:
I HAVE EXAMINED THE ABOVE NAMED PATIENT AND FOUND: (a) NO MEDICAL REASON WHY HE/SHE SHOULD NOT DO THE PURIFICATION RUNDOWN.
SIGNATURE DOCTOR'S NAME
DAT E
(b) HE/SHE IS UNFIT TO DO THE PURIFICATION RUNDOWN. STATE REASONS:
SIGNATURE DOCTOR'S NAME DATE
(c) IF THE PERSON IS IN YOUR OPINION NOT FIT ENOUGH AT THE PRESENT TIME TO DO THE PURIFICATION RUNDOWN PLEASE INDICATE BELOW YOUR RECOMMENDATIONS CONCERNING AN EXERCISE PROGRAM AND/OR DIETARY PROGRAM THAT WOULD ENABLE HIM/HER TO ATTAIN A DEGREE OF FITNESS TO COMMENCE THE RUNDOWN.
xiemnluR. and Pur li<al ,on R-dann are IiudeTa^V.s and xrsica marls .n Kcli Sirs s lechnnk)gi Cen^r, a^^c ai. ixd..yin _ p n ss.a^a Pr,med . h< 1S
PURIFICATION RUNDOWN
DA I LY R EPO R T FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED DATE
DAY 1
UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (IU)
B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG)
AMOUNT OF WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY? SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PACE 2
AMOUNT OF TIME YOU HOURS MINUTES SWEATED IN THE SAUNA TODAY:
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
ANY WINS OR REALIZATIONS THAT OCCURRED?
I ATTEST THAT I I ]AVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
WHEN YOU HAVE FILLED OUT AND SIGNED THIS FORM, HAND YOUR BOOK IN TO THE PURIF I/C
PAGE 3
THIS SECTION FILLED OUT BY PURIF RD I/C:

(1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:
(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR TI iE C/S:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
PURIFICATION I/C DATE
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND TI IEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR:
(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES,
CASE SUPERVISOR
DA I F
DA I LY REPO R T FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIML SIARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WFIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF Wti\I ER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 2
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI -MINERALS (TABLETS)
NIACIN (MG)
WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEET' LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU SWEATED IN THE SAUNA TODAY:
HOURS MINUTES
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REA( TIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
ki
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR THE C/S:
(4) 1 ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA ILY R EPORT FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 3
B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
IF ANY REACTION TO THE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
NUMBER HOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
ANY OTHER VITAMINS TAKEN TODAY? WHAT? HOW MUCH?
WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
I ATTEST TI HAT I HAVE FOLLO\VED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR TI IF C/S:
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCI IONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DAILY R EPO R T FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY DATE
DAY 4
UNITS/MG OF VITAMINS TAKEN TODAY A (I U) D (I U)
B COMPLEX E (MG) (IU)
C B1 (MG) (MG)
MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS SWTATFD IN THE SAUNA TODAY:
MINUTES
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)
(PC SIGNATURE)
PAGE 3

(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF 11C.
CASE SUPERVISOR
DATE
DA ILY RE P OR T FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL I IME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 5
UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (I U)
B COMPLEX E (MG) (IU) C 131 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
ANY CRAVINGS FOR ANY IF ANY REACT ION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUN IS)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS / MINUTES OF RUNNING FODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? ( MENTAL CHANGES , PHYSICAL CHANGES , REACTIONS, DISCOMFORTS , ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
I ATTEST THAT I RAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
DA ILY R EPO R T FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME DATE
DAY 6
TIME STARTED UNITS/MG OF VITAMINS TAKEN TODAY TODAY TIME FINISHED A D IODAY (IU) (IU) TOTAL TIME ON PURIF RD TODAY B COMPLEX E ( MG) (IU) B1 (MG)
WEIGHT C AT START (MG)
WEIGHT AT MULTI- MINERALS FINISH (TABLETS) AMOUNT OF NIACIN OIL CONSUMED (MG) AMOUNT OF WHAT REACTION (IF ANY) DID YOU GET SALT TAKEN FROM THE NIACIN TODAY? AMOUNT OF LECITI LIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF CLASSES OF WATER YOU DRANK TODAY NUMBER OF Cl ASSES OF CAL-MAC, YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABI FS EATEN TODAY (TYPES, AMOUNTS) IF ANY REACTION TO THE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, FTC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
HOURS MINUTES
(PC SIGNATURE)
PAGE 3

(1) FNSL!RES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI IE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR: (l) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECI1, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DAILY R EPORT FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGIiT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER Of GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES , AMOUNTS) DATE
DAY 7
UNITS/MG OF VITAMINS TAKEN TODAY
A D (IU) flU)
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
T T F ANY REACTION TO THE NIACIN , WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
CONTINUED NEXT PAGE
PAGE 2
ANY WINS OR REALIZATIONS IHAT (CCURRED?
I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(1) ENSURES PC HAS Ell LED OUT ALL POINTS ABOVE CORRECTLY:
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCT IONS FOR I HE NEXT DAY.
CASE SUPERVISOR
DATE
SUCCESS STORY
PURIFICATION RUNDOWN (This form is provided for your use, should you wish to write down any wins, gains or realizations you've had while on the Purification Rundown thus far.)
NAME
DATE
WITNESS - DATE
Please hand in your success story to the Purif I/C.
NOTICE
If, at this stage of your rundown , you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown . Find out what handlings have been attempted in the Tech Division to this point . Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder. A. General Progress
1. Tell me about your progress so far on the rundown. 2. What difficulties are you experiencing on the rundown? B. Schedule 3. Are you on a regular daily schedule for doing the rundown? What is it? (If not , find out why not.) 4. Any bugs on keeping your rundown schedule?
5. Briefly outline your daily personal schedule ( sleep , meals, work , transport , " free time ," etc.). 6. Any problems maintaining your personal schedule?
7. How many hours of sleep are you actually getting each night? 8. Are you sleeping well? Do you feel rested when you wake up?
C. Exercise and Sauna 9. What sort of exercise are you doing daily? 10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna? 12. Is the sauna kept clean? 13. Are salt and potassium tablets available to you in the sauna area?
D. Vitamins , Minerals and Niacin 14. Are you taking all the vitamins directed by the C/S, daily? 15. Any adverse reaction to any of the vitamins?
16. Have your vitamin dosages been increased since the start of the rundown? Has the increase been on a gradient?
17. Have amounts of each vitamin been increased proportionally, to your knowledge? 18. Are all vitamins and minerals recommended by the C/S available for you to take, every day? (i.e., are vitamins kept in adequate supply?)
19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished?
E. Diet and Supplements 21. Outline your diet since starting the rundown. 22. Have you made any changes in your diet?
23. What vegetables are you eating daily? How are they cooked? 24. Are you taking the full amount of oil recommended by the C/S daily? 25. Are you taking the full amount of lecithin recommended by the C/S daily?
26. Are you taking the full amount of Cal-Mag recommended by the C/S daily?
F. Changes Experienced
27. Have you noticed any physical changes since starting the rundown?
28. Have you noticed any mental or emotional changes, or changes in attitude since starting the rundown?
29. Have there been any changes in your energy level? 30. Have you noticed any perception changes?
31. Have you had a big win that hasn't been acknowledged?
32. Have any reactions appeared that are persisting?
33. Do you find that you tend to tire out after a certain point when doing the rundown , and make little or no noticeable gain after that point for the day?
G. Twin
34. Are there any difficulties with your twin? 35. Has anything occured with your twin that you would like to make known?
H. Other
36. Were you given any special orders by your doctor to be followed while on the rundown ? Are you following them exactly?
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment , drugs , shock or institutional treatment that you haven ' t mentioned? 40. Do you have any illness that you haven' t mentioned? 41. Any other difficulties or questions? 42. Anything else that you'd like the C/S to know? Qua[ Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc's Purification folder to the Snr C/ S for rapid handling.
Qual Sec Snr C/ S studies the pc's Purification folder and the data gathered in
this interview and the above inspection , and writes crams to correct the outnesses found. Snr C/S
Snr C/S writes the next C/S and routes the folder to the Purif I/C via the Purif C/S. Snr C/S
Purif I/C sees that any C/S ordered handlings are done. Purif I/C This form and all worksheets, etc., connected to it become part of the pc's Purif folder.
IF YOU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET.)
ROUTE TO: REPORTS OFFICER

RELIGIOUS TECHNOLOGY CENTER
Report of Nonstandard Purification Rundown Delivery:

NAME: HOME ADDRESS: DATE:
PHONE :
NAME OF ORGANIZATION IN WHICH PURIFICATION RUNDOWN IS BEING RECEIVED:
ORGANIZATION ADDRESS:
NAME OF PURIFICATION RUNDOWN IN-CHARGE: OBSERVATIONS - (BE SPECIFIC , GIVING DATES, TIMES AND DETAILS OF OCCURRENCES BEING REPORTED, INCLUDING NAMES OF THOSE PRESENT OR INVOLVED. USE EXTRA PAPER IF NEEDED.) I
t
ANY ATTEMPTS TO HANDLE OR CORRECT THE SITUATION, AND RESULTS OF SUCH ATTEMPTS:
ANY ADDITIONAL COMMENTS:
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100 , Los Angeles , California 90028-5107.
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI IIN TAKEN AMOU N1 OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 8
B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER I TOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
ANY OTI IER VITAMINS TAKEN TODAY? WHAT? HOW MUCH?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWFATFD IN THE SAUNA TODAY:
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR:
(1) STUDIES THIS REPORT (AI ONG WITH ANY OTI (ER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
CASE SUPERVISOR
DA1 E
DAILY R EPORT FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON I'URIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED DATE
DAY 9
UNITS / MG OF VITAMINS TAKEN TODAY
A D (I U) (I U)
B COMPLEX E (MG) ((UI C BI (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG)
AMOUNT OF WHAT REACTION (IF ANY) DID YOU GET SALT TAKEN FROM THE NIACIN TODAY? AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) IF ANY REACTION TO THE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
ANY OTHER VITAMINS TAKEN TODAY? WHAT? I IOW MUCH?
CONTINUED NEXT PAGE
PAGE 2
I ATTEST TI (AT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE3 THIS SECTION FILLED OUT BY PURIF RD I/C: (1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
CASE SUPERVISOR:
(1) STUDIES THIS REPORT (ALONG WITH ANY OTIiER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS HIS WRITTEN INSTRUCT IONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
CASE SUPERVISOR
DATE
D A ILY R E P O R T F O R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY DATE
DAY 10
TIME FINISHED A D TODAY (I U) (I U) TOTAL TIME ON B COMPLEX E PURIF RD TODAY (MG) (IU) WEIGHT C AT START (MG) B1 (MG)
WEIGHT Al MULTI- MINERALS FINISH (TABLETS) AMOUNT OF NIACIN OIL CONSUMED (MG) AMOUNT OF WHAT REAC FION (IF ANY) DID YOU GET SALT TAKEN FROM THE NIACIN TODAY? AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC; YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
CONTINUE) ) NEXT PAGE
PAGE 2
HOURS MINUTES
(PC SIGNATURE)
PAGE 3

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC: AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
PURIFI (ATION I/C DATE
WI TEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND TI IEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR:
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCT IONS FOR THE PC ' S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECI i, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA ILY R E P O RT F O R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUN I OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF CI ASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY ( TYPES , AMOUNTS) DATE
DAY 11
I UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI-MINERALS (TABLETS)
NIACIN (MG)
WI LA] REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER I TOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CON I INUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR TI HE C/S:
(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND 1 HE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
(2) PU IS HIS WRITTEN INSTRUCTIONS AND TI 1)5 REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR AUDI FIVES.
CASE SUPERVISOR
DATE
DA I LY RE P ORT FORM
MUST BE FILLED OUT AND TURNED IN TO THE Pl1RIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TO1AL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WAFER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY
DAY 12
B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS)
NIACIN (MG)
WHAT REACTION IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER FLOURS OF ANY OTHER VITAMINS TAKEN TODAY? WHAT? HOW MUCH? SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WI TILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

(1) ENSURES PC HAS FIRED OUT ALL POINTS ABOVE CORRECTLY:
(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR TI IF C/S:
(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH. WITH NO VARIATIONS OR ADDITIVES.
PURIFICATION I/C DAI F
(2) PUTS HIS WRITTEN INS1 RU( TIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECI I, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DALE
DA ILY REPORT FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC; YOU DRANK TODAY DATE
DAY 13
A D (I U) (I U)
C B1 (MG) (MG)
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY ( TYPES , AMOUNTS)
NUMBER HOURS OF ANY OTI IER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SALINA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
(PC SIGNATURE)
PAGE 3

(1) ENSURES P( ILAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(4) 1 ATTEST THAT I HAVE SUPERVISE[) THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND TI iEM TO THE CASE SUPERVISOR IN II IE PC'S FOLDER.
(2) PUTS THIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO I HE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING 10 STANDARD TECH, WITI-H NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DAT F
DA ILY REPO R T FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WFIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SAIT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF CLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 14
A (IU)
D (I U)
B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
IF ANY REACT ION 10 THE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
NUMBER HOURS OF SLEEP LAST NIGHT HOURS' 'MINUTES OF RUNNING TODAY
CONIINI'FD NEXT PAGE
PACE 2
I ATTEST TI ]AT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TI IF C/S IN DOING TFIE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
SUCCESS STORY
(This form is provided for your use, should you wish to write down any wins, gains or realizations you've had while on the Purification Rundown thus far.)
NAME
DATE
WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder.
A. General Progress
1. Tell me about your progress so far on the rundown.
2. What difficulties are you experiencing on the rundown? B. Schedule

3. Are you on a regular daily schedule for doing the rundown? What is it? (If not , find out why not.)
4. Any bugs on keeping your rundown schedule?

5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.). 6. Any problems maintaining your personal schedule?
C. Exercise and Sauna
9. What sort of exercise are you doing daily?

10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna? 12. Is the sauna kept clean?
13. Are salt and potassium tablets available to you in the sauna area?
D. Vitamins, Minerals and Niacin 14. Are you taking all the vitamins directed by the C/S, daily? 15. Any adverse reaction to any of the vitamins?
16. Have your vitamin dosages been increased since the start of the rundown? Has the increase been on a gradient? 17. Have amounts of each vitamin been increased proportionally, to your knowledge?
18. Are all vitamins and minerals recommended by the C/S available for you to take, every day? (i.e., are vitamins kept in adequate supply?) 19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished?
E. Diet and Supplements

21. Outline your diet since starting the rundown. 22. Have you made any changes in your diet?
23. What vegetables are you eating daily? How are they cooked? 24. Are you taking the full amount of oil recommended by the C/S daily? 25. Are you taking the full amount of lecithin recommended by the C/S daily?
26. Are you taking the full amount of Cal-Mag recommended by the C/S daily?
27. Have you noticed any physical changes since starting the rundown? 28. Have you noticed any mental or emotional changes, or changes in attitude since starting the rundown? 29. Have there been any changes in your energy level? 30. Have you noticed any perception changes?
32. Have any reactions appeared that are persisting? 33. Do you find that you tend to tire out after a certain point when doing the rundown, and make little or no noticeable gain after that point for the day? G. Twin
H. Other
36. Were you given any special orders by your doctor to be followed while on the rundown? Are you following them exactly?
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven't mentioned? 40. Do you have any illness that you haven' t mentioned? 41. Any other difficulties or questions?
42. Anything else that you'd like the C/S to know?

Qual Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R).
Qual Sec Send the results of the above inspection and the pc's Purification
folder to the Snr C/S for rapid handling.
Qual Sec Snr C/S studies the pc's Purification folder and the data gathered in
this interview and the above inspection, and writes crams to correct the outnesses found.
Snr C/S
Snr C/S writes the next C/ S and routes the folder to the Purif I/C via the Purif C/S. Snr C/S
Purif I/C sees that any C/S ordered handlings are done. Purif I/C This form and all worksheets, etc., connected to it become part of the pc's Purif folder.
IF YOU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET)


PHONE
NAME OF PURIFICATION RUNDOWN IN-CHARGE: OBSERVATIONS - (BE SPECIFIC , GIVING DATES, TIMES AND DETAILS OF OCCURRENCES BEING REPORTED, INCLUDING NAMES OF THOSE PRESENT OR INVOLVED. USE EXTRA PAPER IF NEEDED.)
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100 , Los Angeles , California 90028-5107.
DAILY R EPORT FORM

DAY 15
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION If ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER HOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNINGT O DAY
I WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
ANY WINS OR REALIZATIONS I HAT OCCURRED?
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TI iE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY C)TIIER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
CASE SUPERVISOR
DATE
DA I LY REPORT FORM
MUSI BE I'll LED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED 1 ODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START \VEIGI IT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI IIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBI R OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 16
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN IMG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUFD NEXT PA(;F
PACE 2
WHAT DID YOU EXPERIENCE WHILE SWFATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)
ANY WINS OR REALIZATIONS THAT OCCURRFD?
(PC SIGNATURE)
PAGE 3

(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR: (1) STUDIES 1 HIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
CASE SUPERVISOR
DATE
DAY 17
A D (I U) (I U)
B COMPLEX E (MG) (I U) C Bl (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES , PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED FOR TI IF C /S:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND f iHS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR:
(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INST RUCTIONS FOR THE NEXT DAY.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDI I IVES.
(ASE S(1PFRVISOR
DAT E
DA I LY R EPORT FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 18
B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

PURIFICATION I1/C DATE
13) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DAT F
DA I LY REPORT FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOIAL TIME ON PURIF RD TODAY WEIGIiT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 19
A D (I U) (IU)
C Bi (MG) (MG)
NUMBER HOURS OF ANY OTI IER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
D A ILY REP O RT FO RM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI LIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 20
B COMPLEX E (MG) (I U) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER HOURS OF ANY OTI JER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

PURIFICATION I/C DAI E
WHEN THIS FORM HAS BEEN FILLED OU1, TEAR IT AND TFIE PC'S DAILY REPORT OUT AND SEND THEM TO I HE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUL)IES [HIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS HIS WRITTEN INSI RUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCT IONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDII IVES.
CASE SUPERVISOR
DALE
DA I LY R EPOR T FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? DATE
DAY 21
A (IU)
D (IU)
VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER I )OURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI ]AT SHOULD BE NOTED FOR THE C/S:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND THIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND I HE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR
DAT F
SUCC ESS STORY

NAME
DATE
WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder. A. General Progress 1. Tell me about your progress so far on the rundown.

3. Are you on a regular daily schedule for doing the rundown? What is it? (If not, find out why not.)
4. Any bugs on keeping your rundown schedule? 5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.).
6. Any problems maintaining your personal schedule?
7. How many hours of sleep are you actually getting each night? 8. Are you sleeping well? Do you feel rested when you wake up? C. Exercise and Sauna 9. What sort of exercise are you doing daily?
10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna? 12. Is the sauna kept clean? 13. Are salt and potassium tablets available to you in the sauna area?
17. Have amounts of each vitamin been increased proportionally, to your knowledge? 18. Are all vitamins and minerals recommended by the C/S available for you to take, every day? (i.e., are vitamins kept in adequate supply?) 19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished?

23. What vegetables are you eating daily? How are they cooked? 24. Are you taking the full amount of oil recommended by the C/S daily?
25. Are you taking the full amount of lecithin recommended by the C/S daily?
26. Are you taking the full amount of Cal-Mag recommended by the C/S daily? F. Changes Experienced
27. Have you noticed any physical changes since starting the rundown? 28. Have you noticed any mental or emotional changes, or changes in attitude since starting the rundown? 29. Have there been any changes in your energy level? 30. Have you noticed any perception changes? 31. Have you had a big win that hasn't been acknowledged?
32. Have any reactions appeared that are persisting? 33. Do you find that you tend to tire out after a certain point when doing the rundown , and make little or no noticeable gain after that point for the day? G. Twin
34. Are there any difficulties with your twin?

35. Has anything occured with your twin that you would like to make known? H. Other
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven't mentioned? 40. Do you have any illness that you haven't mentioned? 41. Any other difficulties or questions? 42. Anything else that you'd like the C/S to know? Qual Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc's Purification folder to the Snr C/S for rapid handling. Qual Sec Snr C/S studies the pc's Purification folder and the data gathered in this interview and the above inspection, and writes crams to correct the outnesses found. Snr C/S
Snr C/S writes the next C/S and routes the folder to the Purif I/C via the Purif C/S.
Snr C/S
Purif I/C sees that any C/S ordered handlings are done. Purif I/C
This form and all worksheets, etc., connected to it become part of the pc's Purif folder.
IF YOU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET.)


PHONE :
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100, Los Angeles, California 90028-5107.
DA ILY RE P O R T FORM
DAY 22
A D ((U) ((U)
IF ANY REACTION TO THE NIACIN , WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWFATFD IN THE SAUNA TODAY-
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TI IF C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNAL URE)
PAGE 3

(2) ANY SIGNS OF VI IAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:
(ASE SUPERVISOR
DATE
DA I LY R EPOR T FO R M
MUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED I ODAY I IME FINISHED TODAY IOIAL TIME ON P(1RIF RD TODAY W'EIGI)T AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SAI T TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 23
A D (I U) (IU)
B COMPLEX E (MG) (I U) C BE (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN IMG) WI EAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY ( f YPES, AMOUNTS)
NUMBER IiOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGI IT WHAT? I IOW MUCH? HOURS' 'MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING ? ( MENTAL CHANGES , PHYSICAL CHANGES, REACTIONS, DISCOMFORTS , FTC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PACE 2
ANY WINS OR REALIZATIONS II ]AT OCCURRED?
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC; YOU DRANK TODAY DATE
DAY 24
A D (I U) (I U)
B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/ MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
ANY WIN'S OR REALIZATIONS THAT OCCURRED?
(PC SIGNATURE;
PAGE 3

(I) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
CASE SUPERVISOR
DATE
D A ILY R E P O R T FO RM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI UIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 25

C BI (MG) (MG) MULTI -MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWFATFD IN THE SAUNA TODAY-
ANY WINS OR REALIZATIONS THAT O((URRED?
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY T I I E C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE;
PAGE 3

(I) ENSURES P( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
WHEN THIS FORM HAS BEEN FILLED OUT, LEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTI iER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO TI IE PURIF 1/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICAl ION RUNDOWN ACCORDING TO STANDARD T ECI i, WITH NO VARIAI IONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA I LY RE P ORT FO R M
MUSI BE FILLED OUT AND TURNED IN TO THE PU RIF I/C NAME TWIN'S NAME DATE
DAY 26
TIME STARTED UNITS/MG OF VITAMINS TAKEN TODAY TODAY TIME FINISHED A D TODAY (I U) (I U) TOTAL TIME ON B COMPLEX PURIF RD TODAY (MG) (I WEIGHT I AT START WEIGHT FINISH AT E U)
C B I ( MG) (MG)
MULTI -MINERALS ( TABLETS)
AMOUNT OF NIACIN OIL CONSUMED (MG) AMOUNT OF WHAT REACTION IF ANY) DID YOU GET SALT TAKEN FROM THE NIACIN TODAY? A,NIOU N I OF LE( ITI iIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH?
HOURS/MINUTES OF RUNNING TODAY

CONI INCED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
DAILY R EPORT FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWI N'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI UN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 27
A D (I U) (I U)
B COMPLEX E (MG) (I U) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WI ]AT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER FiOURS OF SLEEP LAST NIGI IT HOURS/MINUTES OF RUNNING TODAY
CONTINUED NEXT PAGE
PAGE 2
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANCES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
(PC SIGNATURE)
PAGE 3

(1) ENS[:RFS PC I LAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI LE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
PURIIICATION I/C DATF
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCT IONS FOR THE NEXT DAY.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICAI ION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
(ASE SUPERVISOR
DATE
DA ILY REPO R T FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 28
A (IU)
D (IU)
NUMBER I IOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWFATED IN THE SAUNA TODAY:
(PC SIGNAL URL)
PAGE 3

(I) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI iE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC ' S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO TI HE PURIF I/C.
CASE SUPERVISOR
DAL E
SUCC ESS STORY

NAME
DATE
WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder. A. General Progress 1. Tell me about your progress so far on the rundown.

3. Are you on a regular daily schedule for doing the rundown? What is it? (If not, find out why not.) 4. Any bugs on keeping your rundown schedule? 5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.). 6. Any problems maintaining your personal schedule? 7. How many hours of sleep are you actually getting each night? 8. Are you sleeping well? Do you feel rested when you wake up?

9. What sort of exercise are you doing daily? 10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna? 12. Is the sauna kept clean? 13. Are salt and potassium tablets available to you in the sauna area?
19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished? E. Diet and Supplements
25. Are you taking the full amount of lecithin recommended by the C/S daily?
26. Are you taking the full amount of Cal-Mag recommended by the C/S daily? F. Changes Experienced
32. Have any reactions appeared that are persisting? 33. Do you find that you tend to tire out after a certain point when doing the rundown, and make little or no noticeable gain after that point for the day? G. Twin 34. Are there any difficulties with your twin? 35. Has anything occured with your twin that you would like to make known? H. Other
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven't mentioned? 40. Do you have any illness that you haven't mentioned? 41. Any other difficulties or questions? 42. Anything else that you'd like the C/S to know?
Qual Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc's Purification folder to the Snr C/S for rapid handling.
Qual Sec Snr C/S studies the pc's Purification folder and the data gathered in this interview and the above inspection, and writes crams to correct the outnesses found.
Snr C/S
Snr C/S writes the next C/S and routes the folder to the Purif I/C via the Purif C/S. Snr C/S Purif I/C sees that any C/S ordered handlings are done.
Purif I/C
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100, Los Angeles, California 90028-5107.
IF YOU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE TIIE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET.)
ROUTE TO:
REPORTS OFFICER

PHONE :
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C
NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
DAY 29
DATE
UNITS/MG OF VITAMINS TAKEN TODAY A (I U) D (IU) E
B COMPLEX (MG)
C (MG) MULTI-MINERALS
(I U)
B1 (MG)
(TABLETS) NIACIN L(MG)

NUMBER IiOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
CONTINUED NEXT PAGE
PACE 2
AMOUNT OF TIME YOU SWFATFI7 IN THE SAUNA TODAY:
HOURS MINUTES
(PC SIGNATURE)
PAGE 3

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN [HE PC'S FOLDER.
CASE SUPERVISOR
DAT E
DA I LY REPOR T FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME T IME STARTED TODAY TIME TODAY DATE
DAY 30
UNITS/MG OF VITAMINS TAKEN TODAY FINISHED A D IIU) I( U)
B COMPLEX E TOTAL IIME ON (MG) (I U) PURIF RD TODAY WEIGI iT AT START WEIGHT FINISH AT C Bl ( MG) IMG)
MULTI -MINERALS (TABLETS)
AMOUNT OF NIACIN OIL CONSUMED (MG) AMOUNI OF WHAT REACTION (IF ANY) DID YOU GET SALT TAKEN FROM THE NIACIN TODAY? AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER I FOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY 1VHAT DID YOU EXPERIENCE W'ITILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NFXI I'AGF
PAGE 2
(PC SIGNATURE)
WHEN YOU HAVE FILLED OUT AND SIGNED THIS FORM, HAND YOUR BOOK IN TO THE PURIF IK
PAGE 3

CASE SUPERVISOR:
CASE SUPERVISOR
DATE
DA I LY REPORT FORM
NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WVATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAC; YOU DRANK TODAY DATE
DAY 31
A D (I U) (I U)
B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACI ION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER I TOURS OF I ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PACE 2
(PC SIGNATURE)
PAGE 3

PURIFICATION I/C DAI E
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING 10 STANDARD TECI I, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DAT E
DA I LY RE P ORT FO R M
DAY 32
C BI (MG) (MG)
MULTI- MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUED NEXT PAGE
PAGE 2
ANY WINS OR RLALIZATIONS THAT OCCURRED?
I ATTEST TIiAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(1) ENSURES P ( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(4) I ATTEST THAT I HAVE SUPERVISEI) THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
(3) ATTESTS TI ]AT IIE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING 10 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DAILY R EPOR T FO R M
MUST 13F FILLED OU I AND TURNED IN TO TFiE PURIF I/C
NAME
DAY 33
DATE
TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGIIT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRAN K TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON TI iE PROGRAM? VEGFTABI ES EATEN TODAY (TYPES, AMOUNTS) UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (IU)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, UISCOMFORTS, EIC. USE MORE PAPER IF NEEDED.)
CON IIN UED NEXT PAGE
PACE 2
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
MUST BE FILLED OUI AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED FODAY TIME FINISHED I ODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GI ASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 34
B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG)
WHAT REACTION (IF ANY) DID YOU GET I FROM THE NIACIN TODAY?
L
IF ANY REACTION TO [HE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
NUMBER I ]OURS OF SLEEP LAST NIGHT IiOURS/MINUTES OF RUNNING TODAY
CONTINUED NEXT PAGE
PACE 2
I ATTEST THAT I HAVE FOLI OWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TI iE C/S IN DOING I HE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(1) ENSURES P ( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITFS INSTRUCTIONS FOR THE NEXT DAY.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING FO STANDARD TECH, WITH NO VARIAI IONS OR ADDITIVES.
CASE SUPERVISOR
DATE
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED I ODAY TIME FINISHED 1 ODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SAIT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER CAL-MAG YOU DRANK TODAY OF GLASSES OF DATE
DAY 35
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES TODAY (TYPES, AMOUNTS) EATEN i
NUMBER I TOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WI TILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DIS( OMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS SWEATED IN THE SAUNA TODAY:
MIND FES
IPC SIGNATURE)
PAGE 3

WHEN THIS FORM HAS BEEN FILLED OUI, FEAR LF AND THE PC'S DAILY REPORT OUT AND SEND THEM TO TI IF CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCI IONS FOR THE NEXT DAY.
(2) PUNS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON TI IE PURIFICATION RUNDOWN ACCORDING 10 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
SUCCESS STORY
PURIFICATION RUNDOWN (This form is provided for your use, should you wish to write down any wins, gains or realizations you've had while on the Purification Rundown thus far.)
NAME
DATE
_.
WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder. A. General Progress
1. Tell me about your progress so far on the rundown. 2. What difficulties are you experiencing on the rundown? B. Schedule 3. Are you on a regular daily schedule for doing the rundown? What is it? (If not, find out why not.) 4. Any bugs on keeping your rundown schedule? 5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.). 6. Any problems maintaining your personal schedule?
7. How many hours of sleep are you actually getting each night? 8. Are you sleeping well? Do you feel rested when you wake up? C. Exercise and Sauna 9. What sort of exercise are you doing daily? 10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna? 12. Is the sauna kept clean? 13. Are salt and potassium tablets available to you in the sauna area?
19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an
earlier dosage level had diminished?

25. Are you taking the full amount of lecithin recommended by the C/S daily? 26. Are you taking the full amount of Cal-Mag recommended by the C/S daily?
32. Have any reactions appeared that are persisting? 33. Do you find that you tend to tire out after a certain point when doing the rundown, and make little or no noticeable gain after that point for the day? G. Twin 34. Are there any difficulties with your twin? 35. Has anything occured with your twin that you would like to make known? H. Other
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven't mentioned? 40. Do you have any illness that you haven't mentioned? 41. Any other difficulties or questions? 42. Anything else that you'd like the C/S to know? Qual Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc's Purification folder to the Snr C/S for rapid handling. Qual Sec Snr C/S studies the pc's Purification folder and the data gathered in
this interview and the above inspection, and writes crams to correct the outnesses found.
Snr C/S
Snr C/S
Purif I/C sees that any C/S ordered handlings are done.
Purif I/C This form and all worksheets, etc., connected to it become part of the pc's Purif folder.
IF YOU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING TI IE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET)
ROUTE
T O: REPORTS OFFICER

PHONE :

I
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. It you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100 , Los Angeles, California 90028-5107.
D A ILY R E P O R T FO RM
MUST BE F ILLED OUT AND TURNED IN TO TI IL PURIF I/C
NAME
DAY 36
TD ATE I
TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) -H UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (I U)
NUMBER HOURS Of ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SIVFATFD IN THE SAUNA TODAY:
ANY WINS OR REALIZATIONS I HAT OCCURRLD?
I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C.S IN DOING THE RUNDOWN TODAY.
(PC SIGNAI URLi
PAGE 3

(1) ENSURES PC HAS Ell LED OUT ALL POINTS ABOVE CORRECTLY:
(2) ANY SIGNS OF VITAMIN OR MINFRAI DEFICIENCIES OR IMBALANCES:
(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD Tf HAT SHOULD BE NOTED FOR THE C/S:
(T) 1 ATTEST THAI I HAVE SUPERVISED TI IIS PC AND I IIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
PURIFICATION UC D.ATF
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND 1HE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT 10 THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAIIY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD I ECH, WIl H NO VARIATIONS OR ADDITIVES.
CASE S[PERVISOR
DA1 F
D A IL Y R E P O R T F O R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME DAI L
DAY 37
TIME STARTED UNITS/MG OF VITAMINS TAKEN TODAY TODAY TIME FINISHED A D TODAY (I U) (IU) TOTAL TIME ON B PURIE RD AT COMPLEX E TODAY (MG) (IU) (MG) (MG) S
START
WEIGHT AT MULTI-MINERAI FINISH (TABLETS) AMOUNT OF NIACIN OIL CONSUMED (MG)
AMOUNT OF WI{AT REACTION IF ANY) DID YOU GET SALT TAKEN I FROM T I IF NIA( IN I ODAY? AMOUNT OF LECITI TIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUNIBFR HOURS OF ANY OTI TER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? I IOW MUCFI? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PACE 2
AMOUNT OF TIME YOU HOURS MINUTES SWEATFD IN THE SAMNA TODAY:
WHAT DID YOU EXPERIENCE WHILE SWEATING IN TI IF SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES, REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)
ANY WINS OR REALIZATIONS THAI OCC URRED?
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
D A ILY R E P O RT FO RM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGI I F AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI IIN TAKEN AMOUNT OF POIASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 38
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS)
NIACIN (MG)
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, 1VAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER FLOURS OF ANY OTI IER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUI ES OF RUNNING TODAY WHAT DID YOU EXPERIENCE \VI III F RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWFATED IN THE SAUNA TODAY:
(PC SIGNATURE)
PACE 3

(1 I ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI ]AT SHOULD BE NOTED FOR THE C/S:
WHEN THIS FORM HAS BEEN FILLED OUT TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND I I IEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES 1 HIS REPORT (ALONG WITH ANY OTI IER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUIS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRI,IC[IONS FOR THE PC'S NEXT DAN' ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA ILY RE P ORT FORM

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY ( TYPES, AMOUNTS) DATE
DAY 39
UNITS,/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER I (OURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANCES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONIINUED NEXT PAGE
PACE 2
ANY WINS OR REALIZATIONS I I IAT OCCURRED?
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TILE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD T FCH, WITH NO VARIATIONS OR ADDITIVES.
Wi-1EN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND IHE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES T I iBS REPORT (ALONG WITH ANY OTI iER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS IilS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA ILY REP O RT FO RM
MUST BE FILLED OUT AND TURNED IN TO TI iE PURIF I/C NAME T\VIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGIIT AT START \VEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOU N I OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOU N F OF POTASSIUM TAKEN NUMBER OF GI ASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAI -MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
DAY 40
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (I U) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
IF ANY REACTION TO TI IE NIACIN, WAS IT LESS THAN THE PREVIOUS L)AY ON THE PROGRAM?
NUMBER I IOURS OF SLEEP LAST NIGHT HOURS,'MINUT ES OF RUNNING TODAY
ANY OTI TER VITAMINS TAKEN TODAY? WHAT? HOW MUCH?
CONTINUED NEXT PAGE
PACE 2
HOURS MINUTES
ANY WINS OR REALIZATIONS THAT OCCURRED,
I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(2) ANY SIGNS OF VLIAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN I I IF PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTIiER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PUTS IiIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING 1-0 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DA ILY R EPORT FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY MME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGI)T AT START WEIGHT AT FINISH AMOUNT Of OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF \VAT ER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 41
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (I U)
C B) (MG) (MG)
NUMBER I (OURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY
ANY OTHER VITAMINS TAKEN TODAY? WI ]AT? HOW MUCH?
CONTINUFD NEXT PAGE
PAGE 2
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCT IONS EXACTLY AS GIVEN ME RY THE C/S IN DOING 1 HE RUNDOWN TODAY.
(PC SIGNATUREI
PAGE 3

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RI) THAT SI IOULD BE NOTED FOR TI IF C/S:
(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI IF PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN T IIE PC'S FOLDER.
CASE SUPERVISOR: (1) STUDIES 11IIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
(2) PU IS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR TI IE PC'S NEXT DAY ON TI iE PURIFICAHON RUNDOWN ACCORDING 10 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
D A I LY R E P O RT F O RM
MUST BE FILLED OU f AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME I IME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 42
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (I U) C B) (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? IOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU SWFATFD IN THE SAUNA TODAY:
HOURS MINUTES
ANY WINS OR REALIZATIONS THAI OCCURRED?
(PC SIGNAL URE)
PAGE 3

(2) ANY SIGNS OF VITAMIN OR MINERAI DEFICIENCIES OR IMBALANCES:
(4) 1 ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO SIANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN [HE PC'S I OLDER.
CASE SUPERVISOR: (1) STUDIES THIS REPORT (ALONG WITH ANY OTI IER NEEDED FOLDER STUDY) AND WRITES INSTRU( IIONS FOR THE NEXT DAY.
(2) PUTS HIS WRITTEN INSTRUCT IONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF I/C.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, Willi NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
SUCC ESS STORY

NAME _ _ DATE WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder. A. General Progress 1. Tell me about your progress so far on the rundown. 2. What difficulties are you experiencing on the rundown?
B. Schedule 3. Are you on a regular daily schedule for doing the rundown? What is it? (If not, find out why not.) 4. Any bugs on keeping your rundown schedule?
5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.). 6. Any problems maintaining your personal schedule?

10. Are you exercising enough to get your circulation going well?
It 4 ..... a..,...I,I ,. ,.,;th tho tamriornti iro of the cat inn?
D. Vitamins, Minerals and Niacin 14. Are you taking all the vitamins directed by the C/S, daily? 15. Any adverse reaction to any of the vitamins? 16. Have your vitamin dosages been increased since the start of the rundown? Has the increase been on a gradient?
17. Have amounts of each vitamin been increased proportionally, to your knowledge?
18. Are all vitamins and minerals recommended by the C/S available for you to take, every day? (i.e., are vitamins kept in adequate supply?) 19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished? E. Diet and Supplements
21. Outline your diet since starting the rundown. 22. Have you made any changes in your diet? 23. What vegetables are you eating daily? How are they cooked? 24. Are you taking the full amount of oil recommended by the C/S daily? 25. Are you taking the full amount of lecithin recommended by the C/S daily?
26. Are you taking the full amount of Cal-Mag recommended by the C/S daily? F. Changes Experienced 27. Have you noticed any physical changes since starting the rundown?
32. Have any reactions appeared that are persisting?
33. Do you find that you tend to tire out after a certain point when doing the rundown , and make little or no noticeable gain after that point for the day?
G. Twin
34. Are there any difficulties with your twin?

35. Has anything occured with your twin that you would like to make known?
H. Other 36. Were you given any special orders by your doctor to be followed while on the rundown ? Are you following them exactly?
37. Is there any sort of health or case activity that you are doing in addition to the rundown? 38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven ' t mentioned? 40. Do you have any illness that you haven ' t mentioned? 41. Any other difficulties or questions? 42. Anything else that you'd like the C/ S to know? Qua l Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc ' s Purification
folder to the Snr C/ S for rapid handling.

Qual Sec Snr C/S studies the pc's Purification folder and the data gathered in
this interview and the above inspection , and writes crams to correct the outnesses found.
Snr C/S
Snr C/S writes the next C/S and routes the folder to the Purif I/C via the Purif C/S. Snr C/S Purif I/C sees that any C/S ordered handlings are done. Purif I/C
IF YOU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE TI IE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET)


NAME: HOME ADDRESS:
DATE:
PHONE
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer, Religious Technology Center, c/o 1710 Ivar Avenue, Suite 1100, Los Angeles, California 90028-5107.
DA I LY RE P O R T FORM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY ( TYPES , AMOUNTS) DATE
DAY 43
B COMPLEX E (MG) (IU) C B1 (MG) (MG)

CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE I'C'S FOLDER.
CASE SUPERVISOR: (1) STUDIES THIS RFPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY) AND WRITES INSTRUCTIONS FOR THE NEXT DAY.
CASE SUPERVISOR
DATE
DAY 44
A D (I U) (TU)
B COMPLEX E (MG) (IU) C B) (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWEATFD IN THE SAUNA TODAY:
(PC SIGNATURE)
PAGE 3

(4) I ATTEST THAT I HAVE SUPERVISED TI IIS PC AND HIS TWIN TODAY ON THE PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
DAILY R EPORT FORM

MUSL BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 45
CONTINUED NEXT PAGE
PAGE 2
ANY WINS OR REALIZATIONS THAT O( (URRFD?
(PC SIGNATURE)
PAGE 3

(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER AND SENDS IT TO THE PURIF UC.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECI1, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI LIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GI ASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
DAY 46
B COMPLEX E (MG) (I U) C B1 (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
IF ANY REACTION TO THE NIACIN, WAS IT LESS THAN TI IF PREVIOUS DAY ON THE PROGRAM?
NUMBER I(OURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWTATFD IN THE SAUNA TODAY:
WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANCES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DAT E
DAI LY R EPORT FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN DATE
DAY 47
A (IU)
D (I U)

C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
NUMBER OF GLASSES OF WATER YOU DRANK TODAY

NUMBER OF GLASSES OF CAL-MAC YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) IF ANY REACTION TO THE NIACIN, WAS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU SWFATED IN THE SAUNA TODAY:
HOURS MINUTES
(PC SIGNAFURE)
PAGE 3

CASE SUPERVISOR
DATE
MUST BE FR I ED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY MIME FINISHED I ODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 48
A (IU)
D (IU)
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS MINUTES SWEATFD IN THE SAUNA TODAY:
ANY WINS OR REALIZATIONS IHAT OCCURRED?
(PC SIGNATURE)
PAGE 3

i
CASE SUPERVISOR:
CASE SUPERVISOR
DATE
DAILY RE P ORT FORM

DAY 49
A D (I U) (I U)
C (MG) MULTI- MINERALS

(TABLETS) NIACIN (MG)
B) (MG)
NUMBER IIOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PACE 2
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
SUCC ESS STORY

NAME
DATE
WITNESS DATE
NOTICE
If, at this stage of your rundown, you are unhappy with the service you are receiving or have not experienced noticeable gains from the rundown, report to the Qualifications Secretary and hand him this booklet. The Receptionist will direct you to his office if needed. Instructions to Qual Sec: Interview the person on the E-Meter regarding his progress or lack of it on the rundown. Find out what handlings have been attempted in the Tech Division to this point. Ask questions as needed from the list below to help isolate the difficulty. Ask additional questions if necessary. When the interview is complete and you have discovered the reason(s) for the difficulty, thank the pc for his answers, tear out this form, clip all worksheets to it and place them in the pc's Purification folder.
A. General Progress 1. Tell me about your progress so far on the rundown.

2. What difficulties are you experiencing on the rundown?
B. Schedule 3. Are you on a regular daily schedule for doing the rundown? What is it? ( If not, find out why not.) 4. Any bugs on keeping your rundown schedule? 5. Briefly outline your daily personal schedule (sleep, meals, work, transport, "free time," etc.).
6. Any problems maintaining your personal schedule?

10. Are you exercising enough to get your circulation going well? 11. Any trouble with the temperature of the sauna?
12. Is the sauna kept clean?

13. Are salt and potassium tablets available to you in the sauna area?
19. What sort of reactions have you been having to the niacin? 20. Has your niacin dosage been increased before reactions at an earlier dosage level had diminished?
E. Diet and Supplements 21. Outline your diet since starting the rundown. 22. Have you made any changes in your diet?
25. Are you taking the full amount of lecithin recommended by the C/S daily? 26. Are you taking the full amount of Cal-Mag recommended by the C/S daily?
27. Have you noticed any physical changes since starting the rundown? 28. Have you noticed any mental or emotional changes, or changes in attitude since starting the rundown? 29. Have there been any changes in your energy level? 30. Have you noticed any perception changes?
32. Have any reactions appeared that are persisting? 33. Do you find that you tend to tire out after a certain point when doing the rundown, and make little or no noticeable gain after that point for the day? G. Twin
H. Other
36. Were you given any special orders by your doctor to be followed while on the rundown? Are you following them exactly? 37. Is there any sort of health or case activity that you are doing in addition to the rundown?
38. Has anyone expressed any upset or antagonism regarding your being on the rundown or invalidated the rundown to you? 39. Have you had any psychiatric treatment, drugs, shock or institutional treatment that you haven't mentioned? 40. Do you have any illness that you haven't mentioned? 41. Any other difficulties or questions?
42. Anything else that you'd like the C/S to know? Qual Sec Do a full inspection of the pc's Purification folder and Purif Rundown delivery area and personnel using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). Qual Sec Send the results of the above inspection and the pc's Purification folder to the Snr C/S for rapid handling. Qual Sec Snr C /S studies the pc's Purification folder and the data gathered in
this interview and the above inspection , and writes crams to correct the outnesses found.
Snr C/S
Snr C/S
Purif I/C sees that any C/S ordered handlings are done. Purif I/C
IF YOU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE PAGE HEADED "PURPOSE" AT THE BEGINNING OF THIS BOOKLET)
ROUTE
T O: REPORTS OFFICER

PHONE :
SIGNATURE
Your assistance in Keeping Scientology Working is appreciated. If you have filled out this form, please tear it out and put it in an "OUT" basket, or mail it direct to Reports Officer , Religious Technology Center, c/o 1710 Ivar Avenue , Suite 1100 , Los Angeles , California 90028-5107.
D A ILY R E P O R T F O RM
NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WAFER YOU DRANK TODAY NUMBER OF CLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE
DAY 50
UNITS/MG OF VITAMINS TAKEN TODAY A PU) D (IU)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUI ES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
I ATTEST TI-SAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DA - 1 F
DA ILY R EPO R T FORM

MUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY ( TYPES , AMOUNTS) DATE
DAY 51
A (IU)
D (IU)
B COMPLEX E (MG) (IU) C BI (MG) (MG)

NUMBER HOURS OF ANY OTIiER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU SWFATED IN THE SAUNA TODAY-
HOURS MINUTES
I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY TI iE C/S IN DOING TFiE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON TI IE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.
CASE SUPERVISOR
DATE
D A ILY R E P O RT FO RM
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED I ODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGI IT AT START WEIGI IT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI TIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-R-IAG YOU DRANK TODAY DATE
DAY 52
B COMPLEX E (MG) (I U)
C BI (MG) (MG)
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK ? THAN THE PREVIOUS DAY ON THE PROGRAM? VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBER HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.) I
CONTINUED NEXT PAGE
PAGE 2
(PC SIGNATURE)
PAGE 3

CASE SUPERVISOR
DATE
MUSI BE FIILED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGI IT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITHIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY DATE
DAY 53
B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN FORAY?
ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESS TYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM?
VEGETABLES EATEN TODAY (TYPES, AMOUNTS)
NUMBFR HOURS OF ANY OTHER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
1
(PC SIGNATURE)
PAGE 3

(1) ENSURES P( HAS FILLED OUT ALL POIN IS ABOVE CORRECTLY:
CASE SUPERVISOR
DAT F
DAY 54
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
CONTINUED NEXT PAGE
PAGE 2
AMOUNT OF TIME YOU HOURS SWEATFD IN THE SAUNA TODAY:
MINUTES
(PC SIGNATURE;
PAGE 3

(1) ENSURES P( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:
(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI TAT SHOULD BE NOTED FOR THE C/S:
WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT OUT AND SEND THEM TO I HE CASE SUPERVISOR IN 1 HE PC'S FOLDER.
(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN ACCORDING TO STANDARD TECH, WITI I NO VARIATIONS OR ADDITIVES.
CASE SUPERVIS( )R
DA IE
DAILY R EPORT FORM

MUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME 1IME STARTED TODAY I IME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGHT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI UIN TAKFN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY (TYPES, AMOUNTS) DATE I
DAY 55
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI- MINERALS (TABLETS) NIACIN (MG) WI ]AT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
ANY OTHER VITAMINS TAKEN TODAY? WHAT? HON MUCH?
CONTINUED NFXT PAGE
PAGE 2
ANY WINS OR REALIZATIONS I HAT OCCURRED?
(PC SIGNATURE)
PAGE 3

(1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRE( I LY:
CASE SUPERVISOR
DATE
NOTICE CONCERNING LENGTH OF PURIFICATION RUNDOWN

Pc's Name Purification C/S: Pc's Purification folder and Purif Rundown delivery area and personnel are to be closely inspected at this point for any out-tech that may be causing an overextended rundown, using the Troubleshooting the Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). A thorough check for exact tech application is to be done at this time. Are there any points found in the inspection done per the Troubleshooting the Purification Rundown Pc Checklist that require handling?
Purif C/S On inspection of the pc's folder, is the pc making gains on the rundown?
Purif C/S
Are there any persisting bad indicators that have not been handled? Purif C/S
If the answer to any of the above is nonoptimum, a full Folder Error Summary is done. Purif C/S Pc is programed for handling of errors found in the Folder Error Summary. Purif C/S Program is approved (after study of the folder and Folder Error Summary) by the Senior C/S, or amended as needed. Sn r C/S
Needed handlings are done to proper results.

Purif C/S
Pc is continued on the rundown (or sent to declare if found to have completed). Purif C/S
WHEN Ti ]IS FORM HAS BEEN FILLED OUT, TEAR IT OUT AND PLACE IN THE PC'S FOLDER.
D A I L Y R E P O RT FO R M
MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C NAME TWIN'S NAME TIME STARTED TODAY TIME FINISHED TODAY TOTAL TIME ON PURIF RD TODAY WEIGI IT AT START WEIGHT AT FINISH AMOUNT OF OIL CONSUMED AMOUNT OF SALT TAKEN AMOUNT OF LECITI LIN TAKEN AMOUNT OF POTASSIUM TAKEN NUMBER OF GLASSES OF WATER YOU DRANK TODAY NUMBER OF GLASSES OF CAL-MAG YOU DRANK TODAY ANY CRAVINGS FOR ANY TYPE OF FOOD OR DRINK? VEGETABLES EATEN TODAY ( TYPES , AMOUNTS)
DAY 56
DATE
UNITS/MG OF VITAMINS TAKEN TODAY A D (I U) (IU) B COMPLEX E (MG) (IU) C Bl (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG) WHAT REACTION (IF ANY) DID YOU GET FROM THE NIACIN TODAY?
IF ANY REACTION TO THE NIACIN, 1%AS IT LESS THAN THE PREVIOUS DAY ON THE PROGRAM?
NUMBER I (OURS OF ANY OTT IER VITAMINS TAKEN TODAY? SLEEP LAST NIGHT WHAT? HOW MUCH? HOURS/MINUTES OF RUNNING TODAY WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PI IYSICAL CHANGES, REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)
CONTINUED NEXT PAGE
PAGE 2
I ATTEST TI iAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME BY THE C/S IN DOING THE RUNDOWN TODAY.
(PC SIGNATURE)
PAGE 3

NOTICE TO THE PRECLEAR You have now used the last daily report form in this book. If you have not yet completed the rundown, please go to the bookstore or receptionist and purchase another copy of the book, so that you will have proper forms for use in continuing.
NOTICE TO PURIF I/C

This is the last daily report form in this book . Once it is filled out, send it to the C/S and ensure that the pc obtains another copy of this manual so that he will have proper forms to use in continuing the rundown.
CASE SUPERVISOR
DATE
(There are two copies of this form provided. Please use carbon paper.)
PC EXAMINATION
FORM FOR DECLARE OF COMPLETION OF THE PURIFICATION RUNDOWN
Pc or Pre-OT Name Qua[ Div
Date Time
DO YOU HAVE ANY DOUBTS OR RESERVATIONS CONCERNING ATTESTING TO COMPLETION OF THE PURIFICATION RUNDOWN?
WOULD YOU LIKE TO ATTEST TO COMPLETION OF THE PURIFICATION RUNDOWN?
TA POSITION AND ANY BD PC INDICATORS
STATE OF NEEDLE
F/N INDICATED TO PC?
EXAMINER
TEAR OUT THIS FORM AND PUT IT IN THE PC'S FOLDER.
PC EXAMINATION
FORM FOR DECLARE OF COMPLETION OF THE PURIFICATION RUNDOWN
Pc or Pre-OT Name Date Qual Div Time
DO YOU HAVE ANY DOUBTS OR RESERVATIONS CONCERNING ATTESTING TO COMPLETION OF THE PURIFICATION RUNDOWN?
WOULD YOU LIKE TO ATTEST TO COMPLETION OF THE PURIFICATION RUNDOWN?
TA POSITION AND ANY BD PC INDICATORS STATE OF NEEDLE
F/N INDICATED TO PC? EXAMINER
TEAR OUT THIS FORM AND FILE IN CERTS AND AWARDS FILES.
(There are two copies of this form provided . Please use carbon paper.)
ATTESTATION AT CERTS AND AWARDS

We are not concerned with handling bodies with the Purification Rundown. Our concern is freeing the individual up spiritually. The only dosages recommended are those classified as food. There are no medical recommendations or claims for it. The only claim is future spiritual improvement.
This data is released as a record of researches and results noted. It cannot be construed as a recommendation of medical treatment or medication and it is undertaken or delivered by anyone on his own responsibility. I, , having completed the Purification Rundown, do hereby attest by my signature below that I have, through undergoing the actions of the Purification Rundown, achieved FREEDOM FROM THE RESTIMULATIVE EFFECTS OF DRUGS AND TOXIC RESIDUALS to my complete satisfaction. This statement is made entirely on my own cognizance and without reservation.
PRECLEAR SIGNATURE DATE
WITNESS, C&A PURIFICATION I/C'S NAME
TEAR OUT THIS FORM AND PUT IN THE PC'S FOLDER.
ATTESTATION AT CERTS AND AWARDS

We are not concerned with handling bodies with the Purification Rundown. Our concern is freeing the individual up spiritually. The only dosages recommended are those classified as food. There ate no medical recommendations or claims for it. The only claim is future spiritual improvement.
This data is released as a record of researches and results noted. It cannot be construed as a recommendation of medical treatment or medication and it is undertaken or delivered by anyone on his own responsibility.
I, , having completed the Purification Rundown, do hereby attest by my signature below that I have, through undergoing the actions of the Purification Rundown, achieved FREEDOM FROM THE RESTIMULATIVE EFFECTS OF DRUGS AND TOXIC RESIDUALS to my complete satisfaction. This statement is made entirely on my own cognizance and without reservation.
PRECLEAR SIGNATURE DATE
WITNESS, C&A PURIFICATION I/C'S NAME
TEAR OUT THIS FORM AND FILE IN CERTS AND AWARDS FILES.
(There are two copies of this form provided. Please use carbon paper.)
SUCCESS STORY
NAME
DATE
WITNESS DATE
Tear out this form and put it in the pc's folder
SUCCESS STORY
NAME
DATE
WITNESS DATE Tear out this form and send
it to the Success Officer
LIVE LIFE WITH CERTAINTY!

"When we say that somebody should be in present time we mean he should be in communication with his environment. We mean, further, that he should be in communication with his environment as it exists, not as it existed." L. Ron Hubbard
Upon successful completion of the Purification program, you will be free of the numbing effects of toxic residues from drugs and chemicals. In this new state, you will be at the point where you can take action to restore your full awareness of the world around you and sharpen your abilities to think clearly, perceive and act with certainty. The step for you to take after the Purification program is the
OBJECTIVES
CoAWCowse
A Co-audit is a team of any two people who are helping each other reach a better life with Scientology processing.
TRs (training regimens or routines ) are practical drills that put you at cause over communication - the key to success in all human relationships.
Objective Processing ( Objectives ) is a special program that puts you in touch with and in control of the physical universe-including your own body.
The TRs and Objectives Co-audit Course will put powerful tools in your hands so you can restore your awareness of present time and live a fuller, more vibrant life! Learn how to operate better and more efficiently. Become more aware of the world around you. Gain control of your life!
Contact the Registrar at the Church of Scientology and sign up for the TRs and Objectives Co-audit Course NOW.
C HU RCH A ND ORGA NI ZAT I O N A D D R ESS L I ST

United States
Albuquerque Church of Scientology Clearwater , Florida 34616 Church of Scientology Flag Ship Service Organization c/o Freewinds Relay Office 1 18 N. Fort Harrison Avenue Clearwater , Florida 34615 Columbus Lon g Island Church of Scientology 64 Bethpage Road Hicksville, New York 11801 Los Angeles and vicinity
8106 Menaul Blvd. N.E.

Albuquerque, New Mexico
87110
Atlanta
Church of Scientology 1611 Mt. Vernon Rd. Dunwoody, Georgia 30338 Austin
Church of Scientology
4810 Sunset Boulevard Los Angeles , California 90027 Church of Scientology 1451 Irvine Boulevard Tustin, California 92680
30 North High Street
Columbus , Ohio 43215
Church o f Scientology
2200 Guadalupe Austin , Texas 78705
Dallas Church of Scientology

Celebrity Centre Dallas 1850 Buckner Boulevard Dallas , Texas 75228 Denver Church of Scientology 3385 S. Bannock Englewood, Colorado 801 10 Detroit
1277 East Colorado Boulevard Pasadena, California 91 106 Church of Scientology 15643 Sherman Way Van Nuys , California 91406 Church of Scientology American Saint Hill Organization 1413 L . Ron Hubbard Way Los Angeles, California 90027 Church of Scientology American Saint Hill Foundation 1413 L . Ron Hubbard Wa y Los Angeles, California 90027 Church of Scientology Advanced Organization of Los Angeles 1306 L. Ron Hubbard Way Los Angeles, California 90027 Church of Scientology Celebrity Centre International 5930 Franklin Avenue Hollywood, California 90028
Battle Creek
Church of Scientology 66 East Michigan Avenue Battle Creek , Michigan 49017
Boston
448 Beacon Street
Boston , Massachusetts 021 15 Buffalo
321 Williams Street
836 Main Street Buffalo, New York 14202 Chicago Church of Scientology 3009 North Lincoln Avenue Chicago , Illinois 60657 Cincinnati Church of Scientology 215 West 4th Street , 5th Floor Cincinnati, Ohio 45202
Royal Oak , Michigan 48067 Honolulu Church of Scientology 1 148 Bethel Street Honolulu, Hawaii 96813 Kansas City
Church of Scientology 3619 Broadway

Kansas City, Missouri 641 11 Las Vegas Church of Scientology 846 East Sahara Avenue Las Vegas, Nevada 891 04
Clearwater
Church of Scientology Flag Service Organization
210 South Fort Harrison Avenue
Los Gatos Church of Scientology

650 Saratoga Avenue San Jose, California 951 17 Miami
Phoenix
Tampa
2702 N. 44th St, Suite A100 Mesa, Arizona 85038 Portland C h urc h o f Sciento l ogy
3102 N. Havana Avenue
Tampa, Florida 33607

Washington, DC Founding Church of Scientology of Washington, DC
120 Giralda Avenue Coral Gables , Florida 33134 Minneapolis
708 S. West Salmon St.

Portland, Oregon 97205 Sacramento Church of Scientology 825 15th Street Sacramento, California 95814 Salt Lake City Church of Scientology
1701 20th Street N.W.

Washington, DC 20009
Twin Cities 1011 Nicollet Mall Minneapolis, Minnesota 55403 Mountain View Church of Scientology 117 Easy Street Mountain View, California
Puerto Rico
Hato Rey Church of Scientology
272 JT Piniero Avenue Hyde Park , Hato Rey Puerto Rico 00918
1931 S . 1100 East Salt Lake City, Utah 84106

San Diego Church of Scientology
Canada
Edmonton
94043 Nashville
Church of Scientology Celebrity Centre Nashville 1907 Old Murfreesboro Pike Nashville, Tennessee 37217 New Haven Church of Scientology 909 Whalley Avenue New Haven, Connecticut 06515 New York City C h urc h o f Sciento l ogy 227 West 46th Street
New York City, New York
10206 106th Street N.W.

Edmonton , Alberta Canada T5J 1 H7 Kitchener Church of Scientology
1330 4th Ave.

San Diego, California 92101 San Francisco Church of Scientology 701 Montgomery Street San Francisco, California 941 11 San Jose Church of Scientology 80 E. Rosemary San Jose , California 95112
104 King St. West

Kitchener, Ontario Canada N2G 2K6
Montreal
4489 Pa p ineau Street
Montreal , Quebec
Canada H2H 1T7 Ottawa Church of Scientology 150 Rideau Street, 2nd Floor Ottawa, Ontario Canada K1 N 5X6
10036 Church of Scientology Celebrity Centre New York 65 East 82nd Street
Santa Barbara
Church of Scientology 524 State Street Santa Barbara , California 93101 Seattle Church of Scientology 2226 3rd Avenue Seattle, Washington 98121 St. Louis Church of Scientology 6901 Delmar Boulevard
University City, Missouri 63130
New York City, New York 10028

Orlando Church of Scientology 1830 East Colonial Drive
Orlando, Florida 32803
Quebec
Church of Scientology 350 Bd Chareste Est
Quebec, Quebec
Canada G1 K 3H5
Philadelphia Church of Scientology 1315 Race Street
Philadelphia, Pennsylvania
19107
Toronto Church of Scientology 696 Yonge Street, 2nd Floor Toronto, Ontario Canada M4Y 2A7
Vancouver Church of Scientology 401 West Hasting Street Vancouver, British Columbia Canada V6B 1 L5 Winnipeg Church of Scientology
315 Garry Street, Suite 210 Wi nn i peg, M an i to b a Canada R3B 2G7
Pl y mouth
Church of Scientology 41 Ebrington Street Plymouth , Devon England PL4 9AA Sunderland Church of Scientology 51 Fawcett Street
France
Angers Church of Scientology 6, avenue Montaigne
49100 Angers, France
United Kingdom
Birmin g h a m Ch urc h o f S c i ento l ogy Albert House, 3rd Floor 24 Albert Street Birmin g ham , En g land B4 7UD Brighton
Sunderland, Tyne and Wear England SRI IRS
Clermont - Ferrand Church of Scientology 6, rue Dulaure 63000 Clermont-Ferrand,

France
Austria
Vienna Church of Scientology Capistrangsasse, 4 1070 Vienna, Austria
Lyon Church of Scientolog y 3, place des Capucins 69001 Lyon, France Paris
Church of Scientology Third Floor

79-83 North Street Brighton, England BN1 1ZA East Grinstead Church of Scientology Saint Hill Foundation
Saint Hill Manor East Grinstead , West Sussex
Church of Scientology Celebrity Centre Vienna

Senefeldergasse 11/5 1100 Wien, Austria
7 , rue Jules Cesar 75012 Paris, France
Celebrity Centre Paris
69, rue Legendre 75017 Paris, France
Belgium
Brussels Church of Scientology 61 , rue du Prince Royal 1050 Bruxelles , Belgium
Saint - Etienne Church of Scientology

24 , rue Marengo
England RH 19 4JY Advanced Organization Saint Hill

Saint Hill Manor
42000 Saint-Etienne, France
Denmark
Aarhus Church of Scientology
Germany
Berlin Church of Scientology SponholzstraBe 51-52 12159 Berlin, Germany
East Grinstead, West Sussex England RH 19 4JY Edinburgh Hubbard Academy of
Vester AIIe 26
8000 Aarhus C, Denmark Copenhagen Church of Scientology Store Kongensgade 55 1264 Copenhagen K, Denmark Church of Scientology Gammel Kongevej 3-5, 1 1610 Copenhagen V, Denmark Church of Scientology Advanced Organization Saint Hill for Europe and Africa Jernbanegade 6 1608 Copenhagen V, Denmark
Personal independence
20 Southbridge Edinburgh , Scotland EH1 1 LL
Dusseldorf Church of Scientology Friedrichstral3e 28

40217 Dusseldorf, Germany
London
Church of Scientology 68 Tottenham Court Road London, England W1 P OBB Manchester Church of Scientology 258 Deansgate Manchester, England M3 4BG
Church of Scientology Celebrity Centre Dusseldorf

LuisenstraBe 23 40215 Dusseldorf, Germany
Frankfurt Church of Scientology

KaiserstraBe 49
60329 Frankfurt, Germany
H am b urg
Church of Scientology Domstraf3e 12
20095 Hamburg, German y
M on z a Church of Scientology Via Nuova Valassina, 354 20035 Lissone, Italy Novara Church of Scientology Via Passalacqua, 28 28100 Novara, Italy Nuoro Church of Scientology Via Lamarmora , 102 08100 Nuoro , Italy
Portugal
Lisbon
C h urc h o f Sciento l ogy Rua de Prato 185, 2 Andar 1100 Lisbon, Portugal
Church of Scientology BrennerstraBe 12

20099 Hamburg, Germany
Russia
Moscow Hubbard Humanitarian Center
Prospect Budyonogo 31
Hanover Church of Scientology

OdeonstraBe 17
30159 Hanover , Germany Munich Church o f Sciento l ogy
105275 Moscow, Russia
Padua
Via Mameli , 1 /5
S p ain
Barcelona
Dianetics Civil Association
Beichstraf3e 12
80802 Munchen, Germany Stuttgart Church of Scientology Hohenheimerstr . 9 70184 Stuttgart, Germany
35131 Padova, Italy
Pordenone
Church of Scientology Via Montereale, 10/C 33170 Pordenone, Italy Rome
C/DOS De Maig 310 Baixos 08025 Barcelona, Spain Madrid Dianetics Civil Association Santa Catalina, 7 28014 Madrid, Spain
Israel
Tel Aviv Colle g e of Dianetics and
Scientology 12 Shontzion Street
Via del Caravita, 5 00 186 Roma, Italy Turin Church of Scientology Via Bersezio, 7 10152 Torino , Ital y Verona Church of Scientology Corso Milano, 84
Sweden
Goteborg Church of Scientology
Varmlandsgatan 16 , 1 tr.
PO Box 57478 61573 Tel Aviv , Israel
413 28 Goteborg, Sweden
Italy
Brescia Church of Scientology
Via Fratelli Bronzetti , 20
Ma l m o
Church of Scientology Porslingsgatan 3 211 32 Malmo, Sweden
37138 Verona, Italy
Netherlands
Amsterdam Church of Scientology
Nieuwe Zijds Voorburgwal 271 1012 RL Amsterdam ,
25122 Brescia, Italy Catania Church of Scientology
Stockholm
Church of Scientology Gotgatan 105 1 16 62 Stockholm, Sweden
Via Garibaldi, 9
95121 C a tan i a, Ita l y Milan Church of Scientology Via Abetone, 10 20137 Milano, Italy
Netherlands
Norway
Oslo Church of Scientology Lille Grensen 3 0159 Oslo, Norway
Switzerland
Basel Church of Scientology Herrengrabenweg 56 4054 Basel, Switzerland
Bern Church of Scientology
Sydney
Harare Church of Scientology

404-409 Pockets Building
Muhlemattstr. 31, Postfach 384

3000 Bern 14, Switzerland Geneva Church of Scientology 12 , rue des Acacias 1227 Carou g e Geneva , Switzerland Lausanne Church o f Scientology 10, rue de la Madeleine 1003 Lausanne, Switzerland Zurich
201 Castlereagh Street
Sydney, New South Wales 2000

Australia Church of Scientology Advanced Organization Saint Hill
50 Jason Moyo Avenue
Harare , Zimbabwe
Johannesburg Church of Scientology
4th Floor, Bud g et House
Australia, New Zealand and

Oceania 19-37 Greek Street Glebe , New South Wales 2037 Australia
130 Main Street Johannesburg 2001 South Africa Church of Scientology No. 108 1st Floor Bordeaux Centre Gordon Rd., Comer Jan Smuts Ave. Blairgowrie, Randburg 2125 S ou th Af r i ca
Japan
Tokyo
Scientology Tokyo 2-11-7 , Kita-Otsuka Toshima-ku
Badenerstrasse 141 8004 Zurich, Switzerland
Australia
Adelaide Church of Scientology
24-28 Waymouth Street Adelaide, South Australia 5000 Australia Brisbane Church of Scientology
106 Edward Street, 2nd Floor
Tok y o , Ja p an 170-004
Port Elizabeth Church of Scientology

2 St. Christopher Place 27 Westbourne Road Central Port Elizabeth 6001 South Africa Pretoria Church of Scientology
307 Ancore Building
New Zealand
Auckland Church of Scientology 159 Queen Street, 3rd Floor Auckland 1, New Zealand
Africa
Bulawayo
Church of Scientology Southampton House, Suite 202 Main Street and 9th Ave.
Brisbane, Queensland 4000
Australia Canberra
Church of Scientology 43-45 East Row Canberra City, ACT 2601 Australia Melbourne Church of Scientology 42-44 Russell Street Melbourne, Victoria 3000 Australia Perth Church of Scientology 108 Murray Street Perth, Western Australia 6000 Australia
Corner Jeppe and Esselen Streets Sunnyside, Pretoria 0002 South Africa
Argentina
Buenos Aires Dianetics Association
of Argentina
Bulawayo, Zimbabwe
Cape Town Church of Scientology Ground Floor, Dorlane House 39 Roeland Street Cape Town 8001 South Africa Durban Church of Scientology
20 Buckingham Terrace
2162 Bartolome Mitre Capital Federal Buenos Aires 1039 Ar g entina
Colombia
Bogota Dianetics Cultural Center Carrera 15 #91-96
Westville, 3630 Durban, South Africa
Bogota, Colombia

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DELIVERY MANUAL

Bridge Publications, Inc. 4751 Fountain Avenue

Los Angeles, California 90029 ISBN 0-88404-568-4

1990 L. Ron Hubbard Library All Rights Reserved

for the Purification Rundown.

A DOCTOR'S EVALUATION OF THE PURIFICATION PROGRAM

PURIFICATION RUNDOWN PURPOSE

PURPOSE OF THE PURIFICATION RUNDOWN DELIVERY MANUAL

To use this manual:

CHECKLIST FOR STARTING THE PURIFICATION RUNDOWN

Welcome to the Purification Rundown.

RELEASE OF LIABILITY, INDEMNITY AGREEMENT AND CONTRACT

SIGNATURE ( Participant) (Signature of Parent or Guardian if Minor)

(Printed Full Name)

(Home Street Address) Witness Signature Date

(City and State /Country)

MEDICAL DECLARATION FOR PARTICIPATION IN PURIFICATION RUNDOWNTM

I DECLARE under penalty of perjury under the laws of the

(City) (State/Province and Country)

(Signature) Witness Signature Date

(Signature of Parent or Guardian if a Minor)

, hereby give my consent

to fill out the form below

I B. ARE THERE ANY VITAMIN DEFICIENCIES: Yes No

If yes, please specify the relevant details below.

9. ANY SPECIAL PRECAUTIONS:

SIGNATURE DOCTOR'S NAME

(b) HE/SHE IS UNFIT TO DO THE PURIFICATION RUNDOWN. STATE REASONS:

SIGNATURE DOCTOR'S NAME DATE

UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (IU)

B COMPLEX E (MG) (IU) C B1 (MG) (MG) MULTI-MINERALS (TABLETS) NIACIN (MG)

CONTINUED NEXT PAGE

AMOUNT OF TIME YOU HOURS MINUTES SWEATED IN THE SAUNA TODAY:

ANY WINS OR REALIZATIONS THAT OCCURRED?

THIS SECTION FILLED OUT BY PURIF RD I/C:

(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:

PURIFICATION I/C DATE

UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (IU)

B COMPLEX E (MG) (IU) C BI (MG) (MG) MULTI -MINERALS (TABLETS)

CONTINUED NEXT PAGE

AMOUNT OF TIME YOU SWEATED IN THE SAUNA TODAY:

ANY WINS OR REALIZATIONS THAT OCCURRED?

THIS SECTION FILLED OUT BY PURIF RD I/C:

(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:

PURIFICATION I/C DATE

DA ILY R EPORT FORM

UNITS/MG OF VITAMINS TAKEN TODAY A (IU) D (IU)

NUMBER HOURS OF SLEEP LAST NIGHT HOURS/MINUTES OF RUNNING TODAY

ANY OTHER VITAMINS TAKEN TODAY? WHAT? HOW MUCH?

CONTINUED NEXT PAGE

AMOUNT OF TIME YOU HOURS MINUTES SWEATED IN THE SAUNA TODAY:

ANY WINS OR REALIZATIONS THAT OCCURRED?

THIS SECTION FILLED OUT BY PURIF RD I/C:

(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:

PURIFICATION I/C DATE

DAILY R EPO R T FORM

UNITS/MG OF VITAMINS TAKEN TODAY A (I U) D (I U)

B COMPLEX E (MG) (IU)

CONTINUED NEXT PAGE

AMOUNT OF TIME YOU HOURS SWTATFD IN THE SAUNA TODAY:

ANY WINS OR REALIZATIONS THAT OCCURRED?

THIS SECTION FILLED OUT BY PURIF RD I/C:

(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES: