Are you ready to be in a relationship?

1

I get jealous easily.* This field is required.

YESNO

2

I've been told by friends that I flip out easily.* This field is required.

YESNO

3

I have tried to force someone to do something they did not want to do.* This field is required.

YESNO

4

If my way is the right approach, it's OK to push people to follow.* This field is required.

YESNO

5

I have followed someone/people I know without their knowledge, to keep track of what they are doing and where they are.* This field is required.

YESNO

6

I have checked someone's private messages to see who they were talking to. * This field is required.

YESNO

7

I have done things that hurt someone because they deserved it.* This field is required.

YESNO

8

I feel isolated and alone most of the time. * This field is required.

YESNO

9

I feel like I don't have a trusted adult in my life.* This field is required.

YESNO

10

I don't like talking about my feelings. * This field is required.

YESNO

11

Would you like us to contact you directly?If yes, please leave your contact information below. *to review your selections, click SUBMIT below*

Please enter your phone

Please enter your email

Anything else that you'd like us to know?