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Intake form
Help us serve you better, Tell us about yourself
Name
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Email address
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Phone (optional)
Gender
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Select
Male
Female
Date of birth
City/State
Ethnicity
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White
Black
Hispanic
Asian
Lebanese
Syrian
Palestinian
Iraqi
Jordanian
Yemeni
Pakistan
Bangladesh
Iran
Chaldean
Assyrian
Other Middle Eastern
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Other
Religion (optional)
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Islam sunni
Islam Shia
Christianity
Catholic
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Orthodox
Judaism
Hinduism
Buddhism
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Marital status
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Single
Divorced
Widowed
Separated
Do you have children?
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Yes
No
Expecting
Profession
Education
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High School
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate
Lifestyle
Please select at least one option.
Health-conscious
Active lifestyle
Homebody
Social
Career-focused
Family-oriented
What are you looking for in a match?
Please select at least one option.
Preferred age
Same ethnicity
Same religion
Openness to children
Shared values
Location preference
What are some red flags you want to avoid?
Please select at least one option.
Substance abuse
Lack of ambition
Dishonesty
Different values
Poor communication
Additional questions or comments
What is your preferred age range?
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18-25
26-30
31-35
36-40
41-45
46-50
51+
What is your preferred height range?
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Under 5'0"
5'0" - 5'4"
5'5" - 5'9"
5'10" - 6'0"
Over 6'0"
What languages do you speak?
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English
Arabic
French
Spanish
Do you smoke?
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Yes
No
Occasionally
Do you drink alcohol?
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Yes
No
Occasionally
What are your hobbies or interests?
How often do you exercise?
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Never
Rarely
Sometimes
Often
Always
What values are important to you in a relationship?
Preferred method of contact
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Email
Phone
Text
What qualities are important to you in a partner?
What is your ideal first date?
What are your expectations for a relationship?
How did you hear about us?
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Social Media
Friend/Family
Online Search
Event
Are you open to long-distance relationships?
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Yes
No
What is your current relationship status?
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Single
Divorced
Widowed
Separated
What is your preferred religious background in a partner?
Please select at least one option.
Muslim
Christian
Jewish
No Preference
What is your preferred income range?
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Less than $50,000
$50,000 - $100,000
$100,000 - $150,000
$150,000 and above
What are your travel preferences?
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Domestic
International
No Preference
What kind of relationship are you looking for?
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Casual
Serious
Marriage
Long-term
What are some of your future goals?
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