You can see an example of the response form here.

There are two parts to the response form, the Topic Responses area and the Image Naming area.

The Topic Responses area (Parts One & Two):

The top half of the response form is where you will record your responses to the Projective Differential rounds for each of your working and anchor topics. This section is also where you will record your 0-10 ratings of each topic.

The form has a column for each topic - including a warmup topic in the first column, and the anchor topic "Prefer" in the last column. The remaining four columns can be used for your working topic(s) and any other anchor topic(s) that you wish to include in your Head-Gut Check session.

Once you have determined what your session topics are, you will write a word or short phrase for each topic at the top of the columns (one topic per column).

When you do the Projective Differential session, you will use the response form to record your choices to "which image is somehow more like your topic?" To do this, you will circle the letter on the right or left side of the column, corresponding to which image in the pair was somehow more like the topic, the image on the left or the image on the right. Each row in a column represents a pair of images. There are 10 pairs of images in each round (i.e., for each topic), so there are 10 rows in each column. When you have completed a round for a topic, your response form will look something like this.

You will do a round, and complete a column on the response form, for each of your topics. After completing a round, the column for that topic should look something like this.

After doing a round for each topic, you will then record L-Mode ratings for each topic. These ratings consist of a rating on a scale from 0-10 for how you feel about each topic right now, with 0 being extremely negative, and 10 being extremely positive. You will place those ratings in the little circles beside each topic number, like this.

The Image Naming area (Part Three):

After completing the Projective Differential session with your topics, and providing the L-Mode ratings, you will use the image naming area to write down a name or description for each image. You will be able to view each image for as long as you like while you complete this section.