The Blended Family Questionnaire
This form is to be completed by persons who are dating, or considering dating, someone who has children that are from a previous relationship; and/or a couple who currently are navigating the challenging terrain of a blended family.
Email address *
How many children do you have? *
Do any of your children have any emotional or physical needs that are an area of concern for you? *
Required
How will we help the children adjust to the new family? *
Your answer
Do you have a child/children that you do not take care of financially or are not involved in their life? *
Required
If you have a child/children that you do not take care of financially or are not involved in their life, please explain why. *
Your answer
How do you envision the blended family? *
Your answer
Do you believe that the blended family should operate as two separate families or as one family? *
Required
Would you agree to taking co-parenting classes if we were to enter into a serious relationship? *
Required
What is you and your significant others spiritual belief? How will you raise the children? *
Your answer
If the co-parent relocates are you and your significant other willing to relocate as well in order to be closer to the child/children? *
Required
What are your house rules and how can you and your significant other combine your respective house rules to represent what is mutually important to the both of you? *
Your answer
How will you and your significant other enforce our rules? *
Your answer
Do you have an high conflict co-parent? *
Required
If you have a high conflict co-parent, please explain what the issues are that you and your significant other could possibly face. *
Your answer
Is there a pending custody/child support court order or modification? *
Required
If there is a pending custody/child support court order or modification please disclose the nature thereof. *
Your answer
Would you be open to you and your significant other having a meeting with the co-parent to establish expectations, boundaries, and discuss how you all will work together? *
If you would not be open to having a meeting with the co-parent, please explain why. *
Your answer
What are your expectation for your significant other as a step/bonus parent? *
Your answer
Who will all be making decisions regarding the children, aside from you and the co-parent (e.g visitation, schedules, activities, etc.)? *
Your answer
What can you do to ensure everyone’s emotional needs are taken care of? *
Your answer
Do you agree with going to see a therapist or a life coach should you need that type of support? *
Required
If you do not agree to seeing a therapist or a life coach, please explain why. *
Your answer
Do you agree that all of the children should be treated equally? *
Required
Do you believe that your children are your children and your significant others children are his/her children; or do you believe that all children are both of your children with no such distinction? *
Your answer
What would you do if a family member or friend left out, or showed favoritism, towards any of the children? How would you address this? *
Your answer
How would you handle it if someone gave gifts to one, or some of the children, opposed to all? *
Your answer
 How will you make your relationship with your significant other a priority while trying to manage the blended family? *
Your answer
What can you and your significant other do as a couple that will keep the romance going? *
Your answer
How will you and your significant other handle your finances? *
Your answer
Will you and your significant other plan vacations that will happen when all of the children are present? *
Required
Will there be events/gatherings that your family may have that your step/bonus children will not be able to attend, because they are not biological family or considered family? *
Required
Does your family have an issue with you entering into a blended family? *
Required
If your family has an issue with you entering into a blended family, how will you navigate through this without allowing it to change the direction of your blended family, and how will you manage the negative emotions regarding this? *
Your answer
Where will you and your significant other live? *
Your answer
Will you and your significant other combine your income? *
Required
Do you pay child support? *
Required
Do you owe back child support? *
Required
If you are in the arrears with your child support please explain why and when it will be paid off. *
Your answer
Do you believe that adult children should still be able to live at home? *
Required
How long should the adult child be allowed to stay home, will he/she contribute to the bills, will he/she have a curfew? *
Your answer
Is there any additional information that you would like to share?
Your answer
A copy of your responses will be emailed to the address you provided.
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