Dating Survey for Families and Professionals of People with Disabilities

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* 1. I am a:

Family member of a person with a disability

Professional in the disability field

Other (please specify)

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* 2. What are your fears and concerns you hear about dating from your loved one or someone you work with? Check all that apply.

Rejection

Lack of confidence

Not believing that one is attractive

Concern about acceptance of disability

Other (please specify)

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* 3. What are YOUR fears and/or frustrations about your loved one or someone you serve, if you're a professional, regarding dating? Check all that apply.

They'll get hurt.

They'll make poor decisions.

They aren't ready.

They lack information.

Other (please specify)

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* 4. What are your hopes in the area of dating and relationships for your loved one or someone you work with?

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* 5. Would you be interested in investing in an online course, which you could do on your own time, that would help your loved one or someone you work with to to successfully date by building confidence, making good choices about who's a right fit for them, and learning fundamental relationship skills?

Yes

If no, please indicate why below.

Other (please specify)

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* 6. Contact Information - if you would like to be on the Radiant Abilities mailing list and find out when we launch this course.

Name

Email Address