loveisrespect visit Follow-up

 
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1. What is your age?
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2. What is your gender?
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3. What is your ethnicity?
4. How long have you been concerned about your relationship?
5. What are you experiencing, or what have you experienced in the past?
6. Have you talked to anyone about what you are experiencing?
7. What made you decide to visit loveisrespect today?
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