Survey for married or widowed people
Please take this survey if you are currently married or are a widow/er.
GENERAL QUESTIONS
What is your gender?
male
female
Are you currently
married
widowed
(please complete this survey as though you were married)
What is your age?
years
What is your spouse's age?
years
How long have you been married?
If widowed, for how long?
EDUCATIONAL QUESTIONS
What is the highest level of education you have completed?
High school/GED
Some college
Associate's Degree
Bachelor's Degree
Doctorate
What is the highest level of education your spouse has completed?
High school/GED
Some college
Associate's Degree
Bachelor's Degree
Doctorate
Number of children with your spouse:
This is marriage number
for me
This is marriage number
for my spouse
DESCRIPTIONS
What best describes your marriage?
I work, my spouse does not
My spouse works, I do not
We both work
Neither of us work
Who earns the most income?
I do
My spouse does
Who puts the most work into your marriage?
I do
My partner does
We make equal effort
Who would your spouse say puts the most into the marriage? S/he would say...
I do
S/he does
We make equal effort
Don't know
Before you met your spouse, what were you looking for in a partner? Check all that apply.
good conversation
shared religious beliefs
shared interests/hobbies
nonsexual intimacy
sexual relationship
other:
casual relationship
exclusive relationship
potential mate
good looks
other:
other:
How would you rate your relationship with your spouse?
Perfect
Great: minimal problems
Good: occasional problems
Okay: frequent problems
Terrible
To what do you credit this?
What do you expect from your spouse? Check all that apply.
honesty
trustworthiness
active sex life
respect
love
validation
friendship
equality
compassion
understanding
other:
commitment
acceptance of my family
acceptance of me as I am
be "head of the household"
share my interests
provide financial stability
prepare my meals
keep up the house
take care of the kids
other:
other:
What does your spouse expect from you? Check all that apply.
honesty
trustworthiness
active sex life
respect
love
validation
friendship
equality
compassion
understanding
other:
commitment
acceptance of his/her family
acceptance of him/her as s/he is
be "head of the household"
share his/her interests
provide financial stability
prepare his/her meals
keep up the house
take care of the kids
other:
other:
How many of your expectations did/does your spouse meet:
WHEN YOU MET?
None
Almost none
Some
About half
Most
Almost all
All
NOW?
None
Almost none
Some
About half
Most
Almost all
All
For what reasons would you consider ending your marriage? Rank the
top three
things. Also, mark a "Y" next to those that apply but are not in the top three, and a "N" next to those that would have no bearing. Finally, rate the severity of the thing necessary for you to want to leave (only where pertinent).
Once/
Marginal
Occasional/
Minimal
Frequent/
Moderate
Constant/
Extreme
infidelity (partner)
dishonesty (partner)
falling "out of love" (either)
loss of respect (either)
grown apart
religious differences
physical abuse
verbal abuse
sexual abuse
emotional abuse
compulsive/addictive behavior (partner)
lack of support (from partner)
loss of job (partner)
sexual incompatability
change in partner's appearance
friend/family preference (you)
other:
other:
other:
other:
EFFORT
Who puts the most work into your marriage?
I do
My partner does
We make equal effort
My spouse would say:
I do
S/he does
We make equal effort
Don't know
Check here if your spouse has taken or will take this survey.
Supplemental Questions
Did you live with your spouse before marriage?
yes
no
What is your definition of marriage?
THANKS FOR COMPLETING THIS SURVEY!
Please give me any comments you may have, or additions or qualifiers to any of the questions above. Please refer to the question number if you are qualifying an answer.
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