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What is your first name?
   
 
 
 
What is your age?
 
 
 
What is your gender?
 
Male
 
Female
 
TransGender
 
GenderQueer
 
 
 
What is your relationship status?
 
Single
 
Partnered
 
 
 
How long have you been with your current partner, or your last partner if you are currently single?
 
1-3 months
 
3-6 months
 
6 months-1 year
 
more than 1 year
 
more than 2 years
 
more than 5 years
 
 
 
Are you currently employed?
 
Yes
 
No
 
 
 
Please specify your occupation / main source of income
   
 
 
 
How would you describe your social life?
 
I have lots of friends and like to spend most of my time with other people
 
I have some friends but like to spend some time on my own
 
I have very few friends and spend most time by myself
 
I am not a people’s person and prefer to be by myself all the time
 
 
 
How many self-help books do you own?
 
1-5
 
6-10
 
11-20
 
21-40
 
41+
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually

 
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