Pre Divorce Survey

Title

First Name*

Last Name*

Email Address*

Private Phone Number

1) Do you and your spouse agree about getting a divorce?*

Yes
No

2) Are you willing to take responsibility for the relationship not working?*

Yes
No

3) Do you still love each other?*

Yes
No

4) In your marriage, were you emotionally involved and open?*

Yes
No

5) Will you be able to put aside your opinions about what went wrong in the relationship to resolve your issues?*

Yes
No

6) Are you and your spouse able to discuss problems calmly, rationally, and without hostility?*

Yes
No

7) Are you very clear about what your primary emotional needs are in resolving this divorce?*

Yes
No

8) Are you willing to accept help from outside sources to resolve your issues?*

Yes
No

9) Do you and your spouse see the benefits of an amicable settlement?*

Yes
No

10) Is there a willingness to cooperate, share information, and work together toward an amicable settlement?*

Yes
No

11) Is it important to you that your spouse feels some sense of satisfaction at the end of this process?*

Yes
No

12) Do you believe that mediating a mutually satisfying divorce is possible given the nature of your relationship?*

Yes
No

13) If you have children together, are you able to cooperate in co-parenting?

Yes
No

14) Are you willing to share custody with your spouse?

Yes
No

15) Do you have a clear financial plan for meeting your income needs?*

Yes
No

16) Do you feel that you or your partner deserve spousal support?*

Yes
No

17) Are you willing to pay/receive support based on the length of your marriage and marital standard of living?*

Yes
No

18) Will you be able to set aside your emotional agenda to resolve all issues in your divorce?*

Yes
No

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