* 1. Which category below includes your age?

* 2. What is your gender?

* 3. Has depression from a relationship ever affected you physically?

* 4. How long was your longest relationship?

* 5. Do you think having a boyfriend or girlfriend makes you or would make you happier?

* 6. Have you ever cheated on someone and/or have been cheated on in a relationship?

* 7. How important is being in a relationship to you?

* 8. Have your relationships ever negatively affected your school/work?

* 9. Does it make a difference to you if your family does not approve of your boyfriend or girlfried?

* 10. Does it matter to you how you and your other half look to others?

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