Romance Survey Thanks For Participating!
Thank you for participating in our romance survey. This survey is designed to help us better understand what is happening in relationships and will assist us in knowing how to better address the needs of couples. Please provide us with feedback by filling in the information below. Thanks!
Survey completed by?
Husband
Wife
Unmarried and not in a relationship
Unmarried and currently in a relationship
How long have you been married?
Not married
Less than one year
1 - 5 Years
5 - 10 Years
Ten - 15 Years
15- 20 Years
20 - 25 Years
25- 30 Years
30- 40 Years
40 - 50 Years
Over 50 Years
If not married, how long have you been dating one particular person?
Less than 6 months
6 months to one year
1 year to 18 months
18 months to 1 year
1 to 2 years
Over 2 years
How many times have you been married?
Never Been Married
First Marriage
Second Marriage
Third Marriage
Fourth Marriage
Fifth Marriage
How many children do you have? What ages?
How many times do you go on a date with your spouse or significant other monthly without kids?
0
1-2 times
3-5 times
Over 5
What qualifies as a date to you?
Do you have a good friendship with your spouse or significant other?
Yes
No
I want to be best friends with but we aren't now.
Not Married
What do you think is the key to keeping your friendship alive in your relationship?
What first attracted you to your spouse or significant other?
What are your favorites characteristics about your spouse or significant other today?
What are the top three things you argue about?
How would you define romance?
Is romance a priority in your relationship?
Yes
No
I want it to be
Don't care
What would improve romance in you relationship?
How often do you give meaningful kisses, hugs, and other touches to one another?
Several times a day
Once a day
Very Seldom
What qualifies as meaningful touch?
How would you define sexual intimacy?
Is sexual intimacy a priority in your relationship?
Yes
No
I want it to be
Don't care
On average, how often are you sexually intimate weekly with your spouse?
5 or more times
4 times
3 times
2 times
1 time
0
I would rate our sexual intimacy as:
Very Satisfying
Satisfying
Just Ok
Poor
What would make your sexual intimacy better?
Do you feel honored or dishonored by your spouse or significant other?
Honored
Dishonored
Why do you feel honored or dishonored?
How would you describe your dream person to be married to?
Would you be interested in a marriage seminar for your church or group?
Yes
No
I would rate our relationship as:
Very Satisfying
Satisfying
Just ok
Unsatisfying
If just ok or dissatisfied, what would help make your relationship better?
Is the current economy placing stress on your relationship?
Yes, extremely
Yes
Somewhat
No
If you attended one of our marriage seminars or retreats, what topics would be of priority to you?
If you attended a relationship seminars for unmarried couples, what topics would be of priority to you?
If United States citizen what state do you live in? If out of United States, what country do you live in?
First Name (Optional)
Last Name (Optional)
Email Address (Optional)
Indicates Response Required