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Relationship Research
*
1.
Gender (assigned or chosen)
(Required.)
Male
Female
GF / NB
Other (please specify)
*
2.
Age Range
(Required.)
18 - 22
23 - 27
28 - 32
33 - 37
38 - 42
43 - 47
48 - 52
53 - 57
58 - 62
63 - 67
68 - 72
73 +
*
3.
Home Life Prior to Age 16
(Required.)
Zero biological parents in the primary residence.
One biological parent in the primary residence.
Two biological parents in the primary residence.
*
4.
Emotional Stability of Your Home Enviornment Prior to Age 16
(Required.)
Least Stable
2
3
4
Most Stable
Stability
Least Stable
2
3
4
Most Stable
*
5.
Role in Your Dynamic
(Required.)
Daddy / Mommy Dom(me)
little
middle
babygirl / boy
Other (please specify)
6.
Any Additional Information You Feel May be Relevant You Would Like to Share