Divorce Survey

A structured questionnaire family law professionals use to gather background on a couple's situation before their first meeting.

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Your Age

Under 25 25-34 35-44 45-54 55 or older

Your Gender

Male Female Other

Years Married

Less than 1 year 1-5 years 6-10 years 11-20 years More than 20 years

Do You Have Children?

Yes No

Are You and Your Spouse Living Separately?

Yes No

How Long Have You Been Living Separately?

Is Your Spouse in a Mental Health or Correctional Institution?

Yes No

Do You Think Your Spouse Will Agree to the Divorce?

Yes No Not sure

Would You Like to Add Anything Else?

Case Reference Number

Full Name

First Name

Last Name

Phone Number

Preferred Contact Method

Email Phone Text Message

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