Additional Family Questions
Answers marked with a * are required.
 
1. At any point in your family history, were you ever:
Check all that apply


*



      
 
 
 
2. At any point in your significant other's family history, were they ever estranged from:
(this question applies to anyone involved with your children.. whether it be an ex or a step)
Check all that apply
*



      
 
 
 
3. Were these estrangements ever resolved?
*


      

 
 
 
4. If you are currently estranged, please check all that apply:
*












      
 
 
 
5. To keep this extra questionnaire on track:
*

      

 
 
 
6. What is your current income bracket?
Please select from the following:
*









      

 
 
 
7. Please select the group that best represents your age:

*




      

 
 
 
8. Did you participate in the previous survey?
If so, please select which one:
*


      

 
 
 
 
 

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