Dad Survey
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1. Default Section
1
. What is your age bracket?
What is your age bracket?
Under 18
19-30
31-50
50+
2
. What is your gender?
What is your gender?
Male
Female
3
. Is your father currently living?
Is your father currently living?
Yes
No
4
. Which best describes the role your father played in raising you:
Which best describes the role your father played in raising you:
He was actively involved
He was semi-involved
He was an absentee father
I never knew him
I knew him, but I wish I didn't
5
. Which of these options best describes the influence of your father? (Choose all that apply)
Which of these options best describes the influence of your father? (Choose all that apply)
He was/is the most influential person in my life
He influenced me to be a better person
His influence caused me to make unwise choices
He was just there, really not positive or negative
He caused me a great deal of pain
His influence has caused great scars in my life
6
. Which of these best describes your father's relationship with your mother?
Which of these best describes your father's relationship with your mother?
There was no relationship
They never had a good relationship
Their relationship ended in divorce
They had an average relationship
They had a model relationship
7
. If your parents divorced, what age were you when they separated?
If your parents divorced, what age were you when they separated?
Under 10 years old
11-18 years old
19-30 years old
Over 30 years old
Not applicable
8
. If your parents divorced while you were young, which best describes the custody situation?
If your parents divorced while you were young, which best describes the custody situation?
I lived with my mother 100% of the time
I lived with my father 100% of the time
I split my time evenly with my mother and father
I lived mostly with my mother
I lived mostly with my father
Not applicable
9
. If your father is living, or if not, if he were alive today, would you consider him one of the first people you would go to for wisdom or advice?
If your father is living, or if not, if he were alive today, would you consider him one of the first people you would go to for wisdom or advice?
Yes
No
Not sure
10
. If your father is not one of the first people from whom you would seek advice, who would that person be?
If your father is not one of the first people from whom you would seek advice, who would that person be?
Mother
Brother or Sister
Friend
Other family member
Pastor
Mentor
Boss
Other
11
. Do you wish your relationship had been/was better with your father?
Do you wish your relationship had been/was better with your father?
Yes
No
12
. Was or is it your goal to parent different from the way your father parented you?
Was or is it your goal to parent different from the way your father parented you?
Strongly Yes
Somewhat Yes
Strongly No
Somewhat No
13
. What one word would you use to describe your father?
What one word would you use to describe your father?
14
. What was the best quality about your father?
What was the best quality about your father?
15
. What was the worst quality about your father?
What was the worst quality about your father?
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