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* 1. What is your marital status? 

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* 2. Do you have a family that includes children from a previous marriage or relationship?

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* 3. What are your greatest concerns regarding your children?

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* 4. Are you, your spouse or child(ren) living with a chronic health or mental health condition?

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* 5. Are you or your spouse combatting a drug, alcohol or gambling addiction?

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* 6. Social media positively affects my relationship with my spouse and/or my child(ren).

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* 7. Have you or your spouse been impacted by domestic violence within the last 3 years?

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* 8. I am very concerned about our present and/or future financial stability.

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* 9. My family has a very strong spiritual foundation.

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* 10. Which areas in your family would you like to see the most improvement? (Check all that apply)

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