Narcissist Apocalypse Domestic Violence Survivor Needs Survey
Sign in to Google to save your progress. Learn more
What is your age? *
What is your gender? *
What is your income?
Clear selection
How many kids do you have living at home under 18?
Clear selection
Do you rent or own your housing? *
In the next 12 months, do you plan on buying a new home? 
Clear selection
In the next 12 months, do you plan on renting new housing?  *
In the next 12 months, do you plan on moving to new housing? 
Clear selection
In the next 12 months, do you plan on opening a new bank account?
Clear selection
What is your current financial institution?
In the next 12 months, do you plan on obtaining home insurance or changing your home insurance provider?
Clear selection
Who is your current home insurance provider?
In the next 12 months, do you plan on obtaining new life insurance or changing your life insurance provider?
Clear selection
Who is your current life insurance provider?
In the next 12 months, do you plan on obtaining a new credit card?
Clear selection
In the next 12 months, do you plan on obtaining a new loan or refinancing a loan?
Clear selection
In the next 12 months, do you plan on leasing or buying a car?
Clear selection
In the next 12 months, do you plan on obtaining car insurance or changing your car insurance provider?
Clear selection
Who is your current car insurance provider?
What kind of car do you currently own?
In the next 12 months, do you plan on renting a car?
Clear selection
In the next 12 months, do you plan on building your credit score?
Clear selection
In the next 12 months, do you plan on changing your cell phone provider?  
Clear selection
Who is your current cell phone provider?
In the next 12 months, do you plan on changing your internet provider?  
Clear selection
Who is your current internet provider?
In the next 12 months, do you plan on changing your cable provider?  
Clear selection
Who is your current cable provider?
What level of education do you currently have?
Clear selection
In the next 12 months, do you plan on furthering your education or upgrading your skill set?
Clear selection
In the next 12 months, are you planning on changing jobs or starting a new career?
Clear selection
In the next 12 months, do you plan on building your financial literacy?
Clear selection
Are you an entrepreneur or planning to start a new business in the next 12 months?
Clear selection
In the next 12 months, do you plan on starting therapy?
Clear selection
In the next 12 months, if you already have a therapist, do you plan on changing therapists?
Clear selection
In the next 12 months, do you plan on joining a support group?
Clear selection
In the next 12 months, do you plan on obtaining a lawyer?
Clear selection
In the next 12 months, do you plan on obtaining a mediator?
Clear selection
In the next 12 months, do you plan on purchasing any of the following things:
In the last 6 months, have you done any of the following activities:
What type of sponsor do you think is a good fit for Narcissist Apocalypse?

If a company sponsors Narcissist Apocalypse, are you more likely to consider their product/service for future purchases?

Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms