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Exit Survey
 
 
Hey everyone!

I really need this survey for my Stats class, I'd really appreciate just 5 minutes of your time!
 
 
 
How would you describe your primary relationship?
 
Female - Female
 
Male - Female
 
Male - Male
 
 
 
How long have you been in this relationship?
 
1-6 months
 
6-12 months
 
>1 year
 
>3 years
 
Other
 
 
 
Ethnicity
African American Asian American Caucasian Native American Other
You
Your significant other
 
 
Religion/Faith
Christian Hindu Islamic Buddhist/Jain Other
You
Your significant other
 
 
How would you rate your level of satisfaction in your current relationship with respect to the following areas?
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Overall quality of your relationship
Sex/Physical Intimacy
Communication
Openness
Compassion
Understanding
Emotional Support
Strength of your relationship
Love/Affection Received
Love/Affection Given
Any public display of affection
Independence
Interdependence
Mutual interests
 
 
For each of the following statements, use the criteria listed that best describes your current primary relationship.
Strongly Agree Agree Unsure Disagree Strongly Disagree
I love my significant other
I am in love with my significant other and often fantasize raising a family with him/her
Physical attraction is important for me
I want to stay in a relationship with my current partner
I have adequate opportunity to personally grow and develop in my relationship
I am dependant upon my significant other for my happiness
I am afraid to be on my own without my significant other
We have good times together often
We make a good couple
I believe my significant other is the one for me
Strongly Agree Agree Unsure Disagree Strongly Disagree
Our communication is effective
I would consider a long-term relationship with my significant other
I would consider long-distance with my significant other
I am happy with the level of intimacy in my relationship
I am interested in having an affair outside of my relationship
I am thinking about leaving the relationship
 
 
 
How often do you and your partner go on dates?
 
Few times a week
 
Once a week
 
Once a month
 
Once every few months
 
Never
 
 
 
How often do you and your partner argue on average?
 
Few times a week
 
Once a week
 
Once a month
 
Once every few months
 
 
 
What (if any) regrets do you have about your relationship?
   
 
 
 
What do you think you and/or your significant other can improve on in your relationship?