Important Information Regarding QoL Study

Please Read: This questionnaire includes 32 questions and takes about 7 minutes to complete.
After you finish, please press "DONE" at the bottom of the screen to ensure your answers are recorded.
These questions are highly confidential. Unless you include your first and last name, I will be unable to interpret your results.
Important: What you receive at the end are not your results—just your answers. I will personally review and share your actual results with you.
If you choose to schedule a consultation, I will need your full name to prepare a custom plan.

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1. Are you a Member of MeDiCo (a Divorce Coaching Program)

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2. Please rank needs or personal development skills you would you like to develop in the next year.

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3. To receive your score please Enter Your First and Last Name

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4. I have taken this survey - Purpose here is to be able to separate this survey from the same survey you may have taken perhaps 3 months ago or 6 months ago

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5. I have been separated for

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6. I'm actively dating casual or long term

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7. Age

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8. How much have you accepted your marriage is over

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9. I'm embracing the Single Life

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10. I feel like no one will ever want me again

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11. I feel about myself

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12. I'm not bragging but I feel I'm attractive to the opposite sex

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13. I am ready to casually or begin a new long term relationship

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14. I continue to have flashbacks and wonder where I went wrong here

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15. When it comes to dating (dating defined as casually or for long term purposes

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16. Right now I just wanna have fun, date, chill, enjoy my time

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17. My relationship with my children has gotten better since this happened

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18. Since this happened, my career is starting to hurt

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19. Do you exercise or workout?

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20. Since the Split

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21. Since My Separation

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22. Since our separation.

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23. I'm currently living

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24. Please Rank What's Been The Hardest Part of Your Divorce

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25. During my divorce, the Police have been called

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26. If Police Were Called 

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27. How long Did I wait until I dated again (casually or long term)

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28. If I could be any famous actor or character in a movie/series, I would like to be and why?

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29. I've sought some kind of 1 on 1 help for what I'm going through.

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30. I've seen YouTube videos of the MensDivorceCoach Channel (formerly ReneSanceMan)

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31. I have thought about hiring a Divorce Coach

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32. What has stopped you about reaching out to Rene as a Divorce Coach

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33. Please Click Here to Make a free 1 on 1 If you're making a 1 on 1 we do a little scientific analysis as to your needs. Feel free to tell us your divorce story. Where' you're at, challenges, hopes, disappointments. No obligation, I just like to know your strengths.

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