(Only you can see this) Hide

Please let us know how we can improve.

Thank you for your feedback!
Show controls

Uh oh, your payment didn’t go through!

(Only you can see this)

Your trial expired. Please select a plan to continue using POWR One

(Only you can see this)

You added paid features to your Form Builder.

Upgrade your plan to publish Form Builder with paid features.
Remove paid features to publish Form Builder for free.

Your submission has been received, but we're still awaiting payment.

Click to reopen payment window

Your submission has been received, but we're still awaiting payment.

Click to reopen payment window

Your submission has been received!

Loading form responses...

The submission limit has been reached for this form.

Romantic Insights Questionnaire

This is your chance to express what’s truly important to you in a relationship.

Your responses to this questionnaire will be kept confidential and will not be disclosed to potential matches. If I identify a promising match for you, I'll contact you to gauge your interest. I'll also provide insights on why I believe the match could be a good fit, drawing from your responses and my interactions with the potential match.

Please take the time to answer these questions thoughtfully and honestly. Detailed responses are crucial to ensure our collaboration is as effective as possible. Rushing through this process may limit its effectiveness.


*Address

- Select -

Under 20 (please note, matchmaking services are only for clients 18+)

20-29

30-39

40-49

50-59

60-69

70+

- Select -

Less than $30k

$30k-59k

60k-99k

100k-149k

150k-199k

200k-299k

300k-499k

500k+

0 out of 250 characters
0 out of 250 characters
0 out of 250 characters
Whoa! This form has detected unusual activity, which might be spam. Please contact support for help if you continue to see this message.