Name
              
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                    First Name 
                   
                
                
                  
                     
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
              
                
            
              Email
              
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              Message
              
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              Hi. Vaccines.
              
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                  I am vaccinated and I want them to be - that is a non-negotiable.
                
                  I am vaccinated and I don't have strong opinions about their status.
                
                  I am vaccinated and I literally don't care at all.
                
                  I am not vaccinated and I literally don't care at all.
                
                  I am not vaccinated and I don't have strong opinions about their status.
                
                  I am not vaccinated and I don't want them to be either - that is a non-negotiable.
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Masks.
              
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                  I do not wear a mask at all.
                
                  I will wear a mask if I have to.
                
                  I wear a mask all of the time.
                
                  I wear a mask sometimes.
                
                  I stress out about this regularly.
                
                  I want them to feel the same way that I do.
                
                  I don't care what they do regarding masks.
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              The 44th President of the United States of America.
              
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                  My Hero
                
                  I like/liked him but he is/was not my hero
                
                  He was/is okay, but I didn't agree with everything
                
                  I really disliked him
                
                  I genuinely struggle to find something positive to say about him
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              The 45th President of the United States of America.
              
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                  My Hero
                
                  I like/liked him but is/was not my hero
                
                  He was/is okay, but I didn't agree with everything
                
                  I really disliked him
                
                  I genuinely struggle to find something positive to say about him
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Mental Health
              
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                  Pre-marital counseling is a necessity.
                
                  I would be open to pre-marital counseling.
                
                  I will never go to pre-marital counseling.
                
                  Therapy with a mental health specialist can be beneficial to anyone.
                
                  I really support going to therapy with a mental health specialist.
                
                  I will support them if they go to therapy with a mental health specialist.
                
                  I will never go to therapy with a mental health specialist.
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Physical Health
              
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                I support the use of... (select all that apply)
                
                  Modern Medicine
                
                  Homeopathic Medicine
                
                  Chiropractic Medicine
                
                  CBD
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Politics
              
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                check all that apply
                
                  I want to be on the exact same page as them
                
                  I want to have similar political views and opinions
                
                  I do not really care what they think/feel politically
                
                  I do not really care about politics
                
                  I do not vote
                
                  I want to know more about politics that I do now
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Young Humans
              
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                check all that apply
                
                  I want to have (more) children someday
                
                  I want to have as many children as possible
                
                  I do not want to have any (more) children at all
                
                  I'm unsure, but I think I would like to have (more) children someday
                
                  I know I want kids but I am flexible about how many/I don't know how many
                
                  I have one child
                
                  I have more than one child
                
                  I would open to them having one or more children
                
                  I would not be open to them having one or more children
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Animals
              
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                Check all that apply
                
                  I have a pet that lives with me and is basically my child
                
                  I have a pet allergy and can't be around some animals
                
                  I really want a pet someday
                
                  I would be open to rehoming my pet if my spouse or child was allergic or unsafe
                
                  I would never rehome my pet if my spouse or child was allergic or unsafe
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Faith
              
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                check all that apply
                
                  I want us to be on the same page in every thing
                
                  I want us to be on the same page with most things
                
                  I believe that Jesus Christ is my Lord and Savior
                
                  I believe the Bible is beneficial and/or essential to my personal growth
                
                  I do not believe the Bible is beneficial or essential to my personal growth
                
                  I do not know how I feel about the Bible
                
                  I made a choice to get baptized (full body immersion) and I am proud of that choice
                
                  I made a choice to get baptized (full body immersion) and I really don't think it matters now
                
                  I made a choice to get baptized (full body immersion) and I regret that decision now
                
                  I have never been baptized and I never plan on it
                
                  I have never been baptized and I don't know if I will or not
                
                  I have never been baptized but I want to
                
                  I do not have any strong opinions about baptism
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Beliefs
              
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                I believe that... (check all that apply)
                
                  If someone does not speak in tongues, I do not believe they will make it into Heaven
                
                  If someone does speak in tongues, I do not believe they will make it into Heaven
                
                  If someone is physically or mentally sick, it is a result of their sin
                
                  Anxiety is a sin
                
                  Women should not wear pants
                
                  Men in church leadership should not have facial hair
                
                  Women should not be leaders in the church
                
                  Women can be leaders in the church
                
                  American flags have no place in the Christian church
                
                  It is amazing to see an American flag in the church
                
                  It doesn't matter if a church does or doesn't have an American flag
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Women's Health
              
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                (check all that apply)
                
                  I believe that pursuing pregnancy is an essential part of a Godly marriage
                
                  I am against wives using birth control
                
                  I am in support of wives using birth control
                
                  I am in support of some forms of birth control pills and IUDs
                
                  I do not know how I feel about birth control pills and IUDs
                
                  I want to learn more about birth control pills and IUDs
                
                  I believe in using family planning (scheduled intimacy to "plan" or "avoid" pregnancy)
                
                  I would like to learn more about  family planning (scheduled intimacy to "plan" or "avoid" pregnancy)
                
                  I am against wives taking Plan B
                
                  I am in support of wives taking Plan B
                
                  I do not know how I feel about Plan B
                
                  I would be in support of terminating a pregnancy where I am one of the biological parents
                
                  I might be in support of terminating a pregnancy where I am one of the biological parents
                
                  I would never support terminating a pregnancy where I am one of the biological parents
                
                  I am against women, married and unmarried, using birth control or anything similar to regulate non-reproductive issues
                
                  If a wife has reproductive health issues it is a spiritual problem
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Men's Health
              
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                  I am in support of husbands wearing condoms
                
                  I am not in support of husbands wearing condoms
                
                  I do not know how I feel about husbands wearing condoms
                
                  I support husbands using medical resources to reverse erectile dysfunction
                
                  I do not support husbands using medical resources to reverse erectile dysfunction
                
                  If a man has reproductive health issues it is a spiritual problem
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Foster Care x Adoption
              
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                (choose all that you agree with, not what you think you should agree with)
                
                  I do not know if I would ever foster or adopt
                
                  I would be open to adoption, but only a baby
                
                  I would be open to adoption, specifically older children/teens who need a home
                
                  I would be open to adopting any age
                
                  I would be open to adopting of the same race
                
                  I would be open to adopting outside of my race
                
                  I am an adoptive parent
                
                  I am a foster parent
                
                  I cannot wait to become a parent and I want to adopt
                
                  I cannot wait to become a foster parent
                
                  Children should be able to live with their biological parents when possible
                
                  Adoption is most often a traumatic experience
                
                  They must be willing to be a foster parent
                
                  They must be willing to be an adoptive parent