Separation & Divorce Survey

Contemplating divorce and separation can be a deeply emotional and challenging journey. This survey is designed to help you reflect on your current situation. It also helps us understand your needs so that we can best assist you in finding realitsic solutions.

Your responses are confidential and aim to offer clarity and support as you navigate this phase of your life. Take your time, answer honestly, and know that you're taking a courageous step toward reducing your emotional pain and cutting your legal costs.

First Name *

Last Name *

Phone *

Email *

I agree to terms & conditions provided by Irooze. By providing my phone number and email, I agree to receive text messages and marketing emails from Irooze. Reply STOP to stop receiving SMS from us.

Are you a mom, dad, or neither? *

Mom

Dad

Neither

How old are you? *

How many children do you have? *

How old are your children? *

What is your status? *

What experience do you have with divorce? *

Have you tried mediation? *

Which country do you live in? *

USA

Canada

Other

Other country (please specify):

Which state do you live in? *

Specify your County, Town or City. *

Which province do you live in?

Specify your city or town *

How did you hear about us*? (Check all that apply) *

Facebook

Google

Instagram

I was referred to you by:

About Yourself. (Select all that apply) *

I want to move forward with my life - I am looking for someone to help me think this through.

I tend to want to control the relationship and it's not helping us at all.

I feel like I lost my self identity and want to rediscover myself.

I want to start the divorce process - I don't know where to start and who to speak with.

I would like things to get better in my relationship - I am looking for solutions.

I am just exploring.

I feel confident about this and am not doubting myself at all.

Other details about yourself (please specify):

About Your Children. (Select all that apply) *

How do I explain the reason for the divorce to my children in an age-appropriate way?

I am deciding if this is the right time for the kids.

How do I divorce with the least negative impact to my children?

How will my kids handle and cope with the divorce?

I am a stay-at-home mom/dad - could I or should I continue doing that?

I am wondering if & how I am equipped to do this alone as a single parent.

I am not sure if I am comfortable and/or capable to be a solo parent.

I wonder if the other parent can handle being a single parent.

I don't need help in this area.

Other concerns about your children (please specify):

Tell us briefly about your current challenges *

Are you a stay at home Mom or Dad? *

Yes

If you're a stay-at-home Mom or Dad with no income, what is your family income? *We want to ensure that we create you an affordable solution.

Would you like to schedule a complimentary call with our Divorce Strategy Specialist to help you create you a customized action plan? *

YES, please!

I am not ready right now to speak with anyone

Would you like to share anything else with us?

After clicking SUBMIT, you will be redirected to our calendar to schedule your free strategy call.