Questionnaire
B. Please Tell Us About Your Relationships.
1. My current relationship and living situation is
(CHOOSE ONE):
____No sex partner now
____Seeing but not living with my sex partner(s)
____Living with a sex partner, without marriage or
life commitment
____Living with a sex partner, with marriage or life
commitment
____Other (please specify)
2. The number of times I have ever (please write
in the number or write "0").
a. Lived with a sex partner I didn't later marry is ________.
b. Been married is ________.
c. Been divorced is________.
d. Been widowed is________.
Remember
The questionnaire is here for VIEWING ONLY.
Please DO NOT send your answers to me.
Copyright 1998, Carol Ellison, Ph.D.
