Thank you for taking the time to complete and return this questionnaire. Your responses will help us know you better and work with you more effectively.

Step 1 of 3

Please use ONE word only to describe:
In ONE sentence, please describe:
Please list all members of your FAMILY OF ORIGIN - including parents, stepparents, sisters and brothers, and any others who lived with you growing up. Also include any very significant person (like a grandparent, aunt, or uncle) who had a major impact on your life.
Significant person (like a grandparent, aunt, or uncle)