How many time have you been married or in a committed relationship?* 1234More than 4Rather Not Say
Who left who?* They Left MeI Left ThemMutualThey Passed AwayRather Not Say
How Long Have You Been Single/Divorced? Less than 6 Months6-12 Months12-18 Months18-24 MonthsMore than 2 YearsRather Not Say
What outcome would you like from this conversation?*
What is your biggest obstacle to achieving that?*
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