What is your email?

What is your relationship status? *

Where do you live? *

Do you have children? *

If so, how old are they?

What is the highest level of education you completed? *

What is your occupation? *

What is your top love language? *

Your worst nightmare is: (you can choose more than one) *

How often do you go to church (pre-quarantine)? *

Do you like to read? *

If so, what do you like to read? (You can choose more than one.) *

How did you find me? *

How do you feel about the skin you’re in? *

Do you love shopping for clothes? *

How do you decide what clothes to buy? *

Do you feel free around food? *

Do you enjoy looking in the mirror? *

Do you wish you could change part of your body? *