1. How long have you been married?
0-5 years5-10 years10-20 years20-30 years30+ years

2. What are the ages of your kids? (Write N/A if you don’t have children.)

3. Have you discussed divorce with your partner?
No, we have never discussed divorce.Yes, but it was more theoretical.Yes, we have discussed the real possibility of divorce in the near future but no decisions were made.Yes, we have discussed divorce in the near future and we are in disagreement (one of us wants to divorce, the other does not).Yes, we have discussed divorce and we are both in agreement divorce is best.

4. Indicate the degree to which you are interested in our services for the following reasons.

Saving money
VerySomewhatA little bitNot at all

Saving time
VerySomewhatA little bitNot at all

Preserving our family
VerySomewhatA little bitNot at all

Avoid the risks associated with a randomly assigned judge
VerySomewhatA little bitNot at all

Customized solution and control over the terms of our divorce (i.e. child custody arrangement, asset division, etc.)
VerySomewhatA little bitNot at all

5. If Divorce Better is not right for you, how do you think you will get divorced?
We will each hire divorce attorneys and make the best of it.We will not use attorneys or outside help and try to figure out how to get divorced by ourselves.We will likely not get divorced.Other.

6. Mark all the statements that resonate.
My relationship with my children is more important than anything.My partner put the kids and me through a lot, and I want him/her to pay.I don’t trust my partner to do what’s right.Getting divorced is the hardest thing I have ever done and I am scared.I just want him/her to hear me, for once.

7. On a scale of 1 to 5, with 1 being “most important” and 5 being “not important at all”, how important is it that your children are not adversely affected by the divorce process?
12345

8. Can you name one good memory with your partner? If so, please describe.

9. Rank your concerns re: the following (1 being most concerned):

Child custody

Child support

Asset division

Debt division

Other (please specify)

10. Can you imagine being happy again?
No, I can’t ever imagine being happy again.While I am currently in the worst place I have ever been, I hold out hope of being happy again.I am happy now and ready to get on with my life.I know that this is temporary and expect that I will experience happiness again.I am ready to be happy again.

11. How did you hear about us?

12. If Google search, what did you search for?

13. May we follow-up by phone? If so, please provide the best number to reach you.

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