Form
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Date of birth?
*
How long have you been single?
*
Why are you single?
*
What made you want to be in a relationship?
*
Which city within Merced County you live in?
*
What made you want to be in a relationship?
*
What are you looking for?
*
Describe your ideal partner?
*
Hobbies
*
Interests
*
Your Ethnicity?
*
Ethnicity of prefer partner?
*
Are you shy and not really talkative?
*
Yes
No
Sometimes
Sexual Orientation
*
Straight
Gay
Lesbian
Bisexual
What's your Gender?
*
Male
Female
About yourself*. [ Introducing yourself by describing what type of person you are ]
*
Languages
*
English
Spanish
Other
What is your current height?
*
What is your preferred height in a partner?[If you don't have a preferred height then just write down [Doesn't Matter]
*
What's your age?
*
Age range of potential partner
*
Age range of desired partner
*
Do you have any means of transportation?
*
What is your weight or body type?
*
Skinny
Average
Muscular
Chubby
Kinda chubby but not so much
Give us a summary about yourself and subjects you wish to talk about with a partner on a date?
*
Do you drink?
*
Non drinker
Sober
Occasionally
Socially
Daily
Do you smoke?
*
Yes
No
Occasionally
Daily
What do you value most in life?
*
describe how important honesty is in a relationship?
*
Are you religious or spiritual? If so, how does that guide your life?
*
What moral boundaries can you not cross in a relationship?
*
How important is tradition to you?
*
Do you believe people can truly change?
*
Do you prefer deep conversations or light-hearted conversations?
*
deep conversations
light-hearted conversations
Are you more introverted or extroverted?
*
introverted
extroverted
How do you express love?
*
What is your attachment style? [example: describe your comfort and confidence in close relationships, fear of rejection and yearning for intimacy, and preference for self-sufficiency or interpersonal distance.]
*
How do you usually respond to conflict?
*
Are you more of a listener or a talker?
*
Listener
Talker
Both
Do you enjoy taking the lead or being led?
*
Lead
Led
Both
Are you a morning person or night owl?
*
Morning person
Night owl
Both
Do you keep a strict routine or go with the flow?
*
Strict routine
Go with the flow
How important is health/fitness to you? explain why?
*
Are you a pet person? If so, dogs, cats, both or any other animal as a pet?
*
Dogs
Cats
Both
Other
How often do you like to socialize?
*
Do you want children someday? If you already have children, how do you see them fitting into a future relationship?
*
How soon do you usually jump straight to sex after the start of a relationship with someone?
*
How important is family in your life?
*
How was your relationship with your parents growing up?
*
Do you believe in marriage?
*
Yes
No
Maybe
Sometimes
How do you feel about long-distance relationships?
*
Are you comfortable showing affection publicly?
*
Yes
No
What does a healthy relationship look like to you?
*
What’s a dealbreaker for you in a partner?
*
How often do you want to spend time with a partner?
*
Do you need space and independence in a relationship, please explain why?
*
How important is physical touch to you?
*
Are you romantic? How do you express it?
*
What would make you fall in love with someone?
*
Would you only date men with good looks or are you instantly more attracted to someone with a good personality?This question is for females only, if you're not a female then just put [NA]
*
Would you only date females with good looks or are you instantly more attracted to someone with a good personality?This question is for males only, if you're not a female then just put [NA]
*
Have your career goals ever impacted your relationships?
*
Yes
No
How important is cultural background in a relationship?
*
Would you date someone from a different culture or religion?
*
Yes
No
Maybe
How do you feel about political differences in a relationship?
*
Do you enjoy festivals, concerts, or crowded social events?
*
Concerts
Crowded social events
Both
How do you feel about celebrating holidays with a partner’s family?
*
What are your thoughts on open or polyamorous relationships?
*
If you had only one year to live, what would you do?
*
If you could go back in time, what would you tell your younger self?
*
Is there a mistake you've made in life that you’ll never forget? Did you learn from that mistake?
*
Do you prefer constant communication or personal space?
*
constant communication
personal space
How important is physical attraction in your relationships?
*
What does loyalty mean to you?
*
What are you truly looking for in a partner right now?
*
Current Date & Time.
*
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Minutes
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PM
AM/PM Option
1. Confidentiality & Privacy: All personal information shared with Merced Matchmaking will remain private and will not be disclosed without the client's consent. 2. In-Person Verification: All clients must complete a verification appointment (in-person or via secure video call) to confirm their identity and eligibility. 3. Background Checks: Merced Matchmaking performs basic background screenings which include ID verification and checks for criminal records. We do not conduct credit or employment checks. 4. Matching Process: Matches are made based on compatibility questionnaires, personal preferences, and interviews. We cannot guarantee a perfect match or relationship outcome. 5. Cancellation Policy: Cancellations must be made at least 24 hours in advance. Repeated no-shows may result in removal from the matchmaking system. 6. Respectful Behavior: Clients must treat all matches and staff with respect. Any reports of harassment, abuse, or inappropriate conduct may result in termination of membership without refund. 7. Non-Transferable Membership: Your membership is personal and cannot be shared or transferred to another individual. 8. Liability Disclaimer: Merced Matchmaking is not liable for any interactions, relationships, or outcomes resulting from connections made through our services. 10. Agreement Acceptance: By signing this form, the client acknowledges they have read, understood, and agreed to abide by the terms outlined above.
*
I Agree
I Disagree
Would you like to be verified during an in-person appointment where you meet our agent personal or would you prefer a video call on zoom to be verified?
*
In-person appointment
Video call appointment
Appointment
*
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