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Romantic Survey
1
What is your gender?
Female
Male
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2
What is your age?
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 - 74
75 or more
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3
What kind of a relationship are you currently in?
Single
Married
In a serious relationship/Engaged
Noting serious for now
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4
How many serious relationships have you had?
None
1 - 3
4 - 6
More than 6
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5
How long have you been together for?
Only a couple of weeks
Less than a year
1 - 3 years
3 - 5 years
5 - 10 years
More than 10 years
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6
How long did you date your current spouse before becoming engaged?
Less than a month
2 - 6 months
7 - 11 months
1 - 2 years
3 - 5 years
More than 5 years
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7
How important is it for you to find a romantic relationship?
1
2
3
4
5
Not at all
Highly important
1
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8
Which qualities are common in the romantic partners you have dated in the past?
Supportive & Encouraging
Critical
Loyal
Unpredictable
Warm & Friendly
Cold & Distant
Strong
Weak
Independent
Dependent
Other
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9
Which qualities does your romantic partner have?
Supportive & Encouraging
Critical
Loyal
Unpredictable
Warm & Friendly
Cold & Distant
Strong
Weak
Independent
Dependent
Other
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10
How comfortable are you with emotional closeness in romantic relationships?
I often want to be closer than my partner and this sometimes cause problems
I often want to be closer than my partner but this does not cause any problem
I am comfortable with emotional closeness as the way it is
Even if I want to be closer, I often push romantic partners away
I often feel uncomfortable when getting too close so I tend to keep my distance
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11
Which of the following does relate to you the most?
I've ended my relationships most of the time
My partners have ended the relationship most of the time
Generally both of the sides have agreed on ending the relationship together
Both me and my partners have ended the relationship
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