Dating Dealbreakers Survey Form
Dating Dealbreakers Survey Form
What is your age range?
*
Please Select
18-24
25-34
35-44
45-54
55+
Which of the following would be a dealbreaker for you in a partner? (Select all that apply)
*
Smoking
Heavy drinking
Different religion
Different political views
Has children
Does not want children
Long distance relationship
Other
How important are the following in a potential partner?
*
Rows
Not important
Somewhat important
Very important
Shared values
1
2
3
Physical attraction
4
5
6
Emotional availability
7
8
9
Financial stability
10
11
12
Sense of humor
13
14
15
Would you consider dating someone who has children?
*
Yes
No
Maybe
Are you open to a long distance relationship?
*
Yes
No
Maybe
How do you feel about your partner having different religious beliefs?
*
Not acceptable
Acceptable if not practiced
Acceptable
Which relationship goals are you looking for?
*
Casual dating
Long-term relationship
Marriage
Open relationship
Other
Rate how much of a dealbreaker the following habits are for you.
*
Rows
Not a dealbreaker
Somewhat a dealbreaker
Major dealbreaker
Smoking
16
17
18
Recreational drug use
19
20
21
Heavy drinking
22
23
24
Lack of ambition
25
26
27
Messy or disorganized
28
29
30
Are there any absolute dealbreakers not listed above?
Submit Survey
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