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Instructions: This survey is about relationships. The information you give will be used to evaluate the Relationship Education Project and to improve dating violence programs for other students. The answers you give will be confidential. No one will know what you write. Answer the questions based on your HONEST opinions. Your feedback is used to create better programs for students!
  • Create a Student ID

    To maintain anonymity and track individual student progress, please create a student ID.
  • If you don’t have a middle name, use the first three letters of your mother’s first name. For example, if your middle name is Apple, you would write APP.
  • If you don’t have three numbers, put zero first. For example, if your street address is 1 Apple Lane, write 001. If your street address is 12 Apple Lane, write 012.
  • Your birth month. For example, March would be 03.
  • Demographics

    Please enter demographic data based on how YOU identify yourself.
  • (or community organization)
  • Relationships

    Instructions: The next 16 questions ask you to think about various things that might happen in a relationship, and to rate them on a scale from healthy to abusive. We are asking you for YOUR OPINIONS about relationships IN GENERAL, not about your ACTUAL experiences. Please read each statement carefully before answering.
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