Relationship Survey for Married Couples

Welcome to our Relationship Survey for Married Couples.

Welcome to the Relationship Survey for Married Couples.

The questions take approximately 30 minutes to complete. All responses are confidential and are intended to provide you will a guide as to whether you may need to speak with a marriage consultant. You are encouraged to contact me at the end of the survey to discuss how I can best help you.

Kind regards,

Julia Nasser

When Harry Married Sally

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About You

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*1.	Where do you live?

Suburb/town
State
Country

*2.	How old are you?

18-24 25-30 31-36 37-42 43-48 49-54 55-65
If other, please specify

*3.	How old is your partner?

18-24 25-30 31-36 37-42 43-48 49-54 55-65
If other, please specify

*4.	What is your sex?

Male Female

*5.	What is your occupation?

*6.	What is your partner's occupation?

*7.	Is this your first marriage?

Yes No

*8.	Is this your partner's first marriage?

Yes No

*9.	How many years have you and your current partner been married?

*10.	If this is your second marriage, for how many years did your first marriage last?

*11.	If this is your partner's second marriage how long did his/her first marriage last?

*12.	Are there any children from your current marriage?

Yes No

*13.	If you answered 'yes' to previous question how many children do you and your partner have?

*14.	If this is a second marriage for either you or your partner, are there any children from an earlier marriage/relationship?

Yes No

*15.	If you answered 'yes' to the previous question how many children are from a previous marriage/relationship?

*16.	How many children currently reside with you and your partner?

*17.	Do you or your partner pay maintenance to a former partner or children?

Yes No

*18.	Did you and your partner live together prior to marriage?

Yes No

*19.	If you answered 'yes' to previous question how long did you live together?

*20.	Are you parents divorced?

Yes No

*21.	Are your partner's parents divorced?

Yes No