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Real Men Change Diapers™
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First Name
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Last Name
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Email
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How did you hear about us?
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If you answered Other above please write in answer
Select the option that best describes you.
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Select an option
What is your gender?
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Man
Women
Non-binary
What is your age
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Under 30
31-40
41-50
51-60
61-70
71+
How old is your spouse?
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Under 30
31-40
41-50
51-60
61-70
71+
How many dependent children are you currently balancing?
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How many aging parents are you currently balancing?
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How many aging parents are you and your spouse currently balancing?
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If you have siblings, are they stepping up to help or are you flying solo as the primary male caregiver?
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Have help
Flying solo
If your spouse has siblings, are they stepping up to help?
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Yes
No
In what state do you reside?
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Select a State
Do your parents live in the same state?
Yes
No
Do your parents live within 30 miles of your home?
Yes
No
Do your in-laws live within 30 miles of your home?
Yes
No
Do your in-laws live in the same state?
Yes
No
On a scale of 1 to 10, how stressed are you honestly feeling? Click on the icons to highlight them.
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No Stress
Very Stressed
What is your profession?
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What company/non-profit do you work with/for?
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What is your role in that company/non-profit?
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Thinking of the people you work with that are in the sandwich generation, how many are males?
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Rate the stress level of the men you work with that are part of the sandwich generation. Click on the icons to highlight them.
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No stress
Highly stressed