Your Perfect Match Questionnaire

Your Perfect Match Questionnaire

Welcome to Simply Matched! I’m so glad you’re here. Please take your time answering honestly - there are no “right” or “wrong” answers. This helps me make thoughtful, genuine matches.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Address (This info helps with match proximity)*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
When a match is made, how would you prefer your match to contact you? (Select all that apply.)*

Phone (Call or text)EmailEither phone or email
How would you describe your physical qualities? (Select all that apply.)*

Fit / AthleticCurvy / Full-figuredAverage buildTallShortWell-groomed / StylishNatural / Casual style
Please select the option that best describes your racial or ethnic background. (Select all that apply.)*

African American / BlackHispanic / Latino / Latina / LatinxWhite / CaucasianAsianNative American / Alaska NativeMiddle Eastern / North AfricanPacific Islander / Native HawaiianMultiracial / MixedPrefer not to answer
At Simply Matched, all members complete a quick identity verification for everyone’s peace of mind. First, please upload a clear photo of your ID below. Next, please schedule a brief Zoom call using my online calendar link: *

Cancelof
Would you be open to purchasing a background check if your match requested it? This step is completely optional. It’s simply a way for matches who value extra peace of mind to build trust with one another.*

Yes, I’d be open to completing a background check upon request.No, I prefer not to complete a background check.
Tell Me About Your Perfect Match

Everyone has different ideas about what makes a great match — from shared interests to chemistry and values. The questions below help me understand what you’re drawn to and who you’d feel most comfortable connecting with. Please also keep an open mind — sometimes the best connections come from people you might not have been immediately drawn to. The strongest chemistry often unfolds naturally — through laughter, comfort, and that effortless feeling of being seen and understood.
What age range are you most comfortable dating?*

25-3536-4546-5556-6566+Open to any age within 10 years of my own
Physical attraction is an important part of connection. Which physical qualities tend to attract you most? (Select all that apply.)*

Fit / AthleticCurvy / Full-figuredAverage buildTallShortWell-groomed / StylishNatural / Casual styleNo specific preference — it’s all about energy and chemistry
Everyone is drawn to different qualities — physical, emotional, and cultural. To help me make compatible matches, please select all the racial or cultural backgrounds you are comfortable dating. There are no right or wrong answers — this simply helps ensure genuine attraction and mutual respect.*

African American / BlackHispanic / Latino / Latina / LatinxWhite / CaucasianAsianNative American / Alaska NativeMiddle Eastern / North AfricanPacific Islander / Native HawaiianMultiracial / MixedNo preference
Relationship & Family Goals
What type of relationship are you looking for?*

A long-term committed relationshipMarriage-mindedCasual dating / companionshipFriendship first – possibly moreOpen to seeing what developsNot sure yet – open to connection
Do you have children?*

Yes, that live with me full timeYes, they live with me part timeMy children are grownI don’t have children right now, but I’d like toI don’t have children and don’t plan to
Are you open to dating someone who already has children??*

Yes, I’m completely open to itPossibly, depending on their situationNo, I’d prefer to date someone without children
Personality Type
How would you describe your personality? (select all that apply)*

Outgoing / SocialEasygoing / Laid-backAmbitious / DrivenThoughtful / QuietFunny / PlayfulNurturing / CaringAdventurous /SpontaneousCreative /ExpressiveIndependent /ConfidentBalanced / Mix of introvert and extrovert
Lifestyle
How important is faith or spirituality in your life?*

VerySomewhatNot Important
Is it important that your match shares your faith or belief system?*

Yes, I prefer a match with the same faithIt's somewhat importantNo, I’m open to different beliefs
What faith or spiritual belief system do you identify with, if any?*
How would you describe your general political views or affiliations?*

ConservativeModerateLiberalIndependentApolitical
How important is it to you that your matchshares your political beliefs?*

Very important, I prefer a partner with similar viewsSomewhat important, open to discussion if we respect each otherNot important, I can connect with people across political lines
How important is career or ambition in your life?*

VerySomewhatNot Important
Would you prefer a partner with a similar level of ambition?*

YesNo Preference
Which best describes your lifestyle?*

Active / Fit / OutdoorsyBalanced between activity & relaxationHomebody / Enjoy quiet eveningsTraveler / ExplorerFamily-orientedCareer-focusedFaith-focusedHealth-consciousArtistic / CreativeCommunity-minded /Volunteer spirit
Habits
Do you smoke or vape?*

YesOccasionally / sociallyNo
Are you comfortable dating someone who smokes or vapes?*

YesOnly occasionally / sociallyNo
Do you drink alcohol?*

Rarely / sociallyRegularlyNever
Are you comfortable dating someone who drinks alcohol?*

YesOnly occasionally / sociallyNo
Do you use marijuana or other recreational drugs?*

NoOccasionallyRegularlyPrefer not to answer
Are you comfortable dating someone who uses marijuana or other recreational drugs?*

Yes, occasional useOnly marijuanaNo
Interests & Hobbies
What do you enjoy doing in your free time? (Select all that apply.)*

Cooking / BakingDining out / Trying new foodsReadingWatching movies or showsMusic / ConcertsAttending live eventsDancingArts & CraftsFitness / Yoga /SportsHiking / Nature walksVolunteeringGardeningPhotographyPets / AnimalsTravelingOther
Core Values

Rank the relationship values below in order of importance to you. 1 = Most important and 13 = Least important. Select a value from each dropdown and place it next to the corresponding number. Each number should have a unique value — no repeats.*

	Which values matter most to you in a relationship?
1 - Most Important
2
3
4
5
6
7
8
9
10
11
12
13 - Least Important

Photo Upload Section
Let’s face it — physical attraction is an important part of finding your true match. While personality, values, and shared goals create lasting connections, that first spark often begins with what we see.

Your photos help me make thoughtful, meaningful matches that reflect both chemistry and compatibility. These photos don’t have to be professional — just genuine, recent, and true to who you are.

Privacy Promise: Your photos and profile are never posted online or shared publicly. They are used exclusively for private matchmaking purposes and will only be shared with individuals I personally believe could be a good fit for you. Protecting your privacy and maintaining trust are top priorities at SimplyMatched.

Please upload three recent photos (taken within the last 6 month) that show your authentic self in the upload boxes below.
Headshot photo upload: A clear photo of your face with good lighting (no sunglasses or heavy filters).

Cancelof
Full-body photo upload: A well-lit photo that shows your natural appearance.

Cancelof
Lifestyle Photo Upload: A photo that highlights your personality, a hobby, or something important in your life.

Cancelof
Coaching Corner: Strengthen YourRelationship Skills

In addition to matchmaking, I’m also a certified Life Coach with a focus on relationships. Sometimes, finding “the one” starts with understanding yourself — your patterns, your needs, and the ways you connect with others. If you’d like personalized guidance, you can schedule a Relationship Coaching Call with me to explore challenges, build confidence, or prepare for a deeper connection. During our session, we’ll identify what’s holding you back and create clear next steps toward a happier, healthier love life. You’ll find a link to schedule a private session after completing this questionnaire.
What has been your biggest challenge in past relationships?*

CommunicationTrustEmotional IntimacyFinding commitment-minded partnersWork/life balanceOther
What relationship patterns would you most like to change or understand better?*

Choosing the wrong partnersFear of vulnerabilityStruggles with self-confidenceDifficulty setting boundariesTrouble trusting othersOther
How readydo you feel to enter a new relationship right now?*

Fully ready and openSomewhat ready — still healing or working onmyselfUnsure — I want to take things slowly
In your own words, describe what you’re looking for in a relationship — the qualities, feelings, and connection that matter most to you.
Simply Matched Client Agreement & Disclaimer
By submitting this profile, I confirm that all information provided is truthful and accurate to the best of my knowledge. I understand that Simply Matched is a professional matchmaking and coaching service, not an online dating site, and that my participation does not guarantee a romantic connection or relationship outcome.

I understand that:
- Simply Matched verifies client identities through photo ID and video confirmation but does not conduct background checks unless arranged independently.
- I am solely responsible for my own personal safety, communications, and interactions with other participants.
- Simply Matched and its representatives are not liable for any damages, losses, or outcomes resulting from introductions or meetings facilitated through the service.
- My photos and personal information will remain private and will only be shared with potential matches identified as suitable by Simply Matched.
By signing below, I acknowledge that I have read and agree to the above terms.
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Should be Empty:

Your Perfect Match Questionnaire

Tell Me About Your Perfect Match

Relationship & Family Goals

Personality Type

Lifestyle

Habits

Interests & Hobbies

Core Values

Photo Upload Section

Coaching Corner: Strengthen YourRelationship Skills

Simply Matched Client Agreement & Disclaimer

By signing below, I acknowledge that I have read and agree to the above terms.