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* 1. What is your age?

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* 2. Do you have kids?

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* 3. If yes, what are their ages?

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* 4. How long was your your relationship with your previous partner?

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* 5. How long have you been separated?

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* 6. How did the separation occur?

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* 7. Were you working at the time?

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* 8. Are you working now?

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* 9. If you have children, what is the current custody arrangement?

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* 10. Where do you live?

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* 11. Through the process of separation and divorce what has been the hardest challenge for you? (Please rank from one to eight with one being the hardest)

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* 12. What was the most important advice that helped you to cope?

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* 13. What have you done or what did you do to help get through that hard time?

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* 14. What is the biggest lesson that you learned or have learned so far from going through this?

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* 15. Is there anything you would do differently if you could go back and change it?

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* 16. Do you feel like you have healed from your separation or divorce?

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* 17. If yes, then when was the moment you knew you had healed and how do you think this has changed you (if at all)?

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* 18. If not yet, what is the biggest struggle to overcome right now?

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* 19. What were some of the things people have said to you that upset you? What do you wish people understood about going through this?

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* 20. What advice would you give to others going through this?

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* 21. If you have time, we would really love to hear your story of divorce and recovery.

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* 22. Please provide your email address if you are interested in receiving a copy of this report?

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