This form started to making its way around multiple Poly e-mail list late in the year 2000. We are not sure of the origin of this Questionnaire. It first came to our attention on the UUPoly e-mail list by Arthur M. Neville. If you know of the person(s) who created this questionnaire please send us an e-mail. We would love to give the creator(s) recognition for their creation. Also, if anyone knows or has any suggestions that would improve this Poly Questionnaire please help us enhance this wonderful personal tool that other PolyFolks have left us to build on. This Questionnaire is great tool to combine with a Poly Personal Ad.
1. Right now I:
( ) Am
( ) Am Not involved with anyone else.
If so, please indicate numbers. Note, one partner can be included in more than one category. You may attach text explaining your answers if you so choose.
My romantic partners include:
( ) legal spouses,
( ) Lifetime commitments,
( ) parents of my children,
( ) very close, ongoing, emotional relationships,
( ) friends whom it's okay for me to be sexual with,
( ) people whom I'm dating,
( ) people with whom I can indulge in non-mainstream (kink or fetish) sexual activities,
( ) partners of the opposite sex,
( ) partners of my own sex,
( ) live-in partners,
( ) partners with veto power over new relationships,
( ) partners with veto power over ongoing relationships,
( ) partners with whom you will be expected to be romantically or sexually involved, if you get involved with me.
( ) Total partners.
2.. I have :
( ) children.
( ) of them live with me full-time.
3.. Right now, I am interested in:
( ) Friendship
( ) Cuddling/Smooching
( ) Talking (includes ordinary emailing)
( ) Sexy Emails
( ) Sex
( ) Kinky Sex
( ) Starting a Short-term Relationship
( ) Starting a Long-Term Relationship
4.. If things go well, within a few weeks of starting a relationship, I will be interested in:
( ) Friendship
( ) Cuddling/Smooching
( ) Talking (includes ordinary emailing)
( ) Sexy Emails
( ) Sex
( ) Kinky Sex
( ) Group Sex
( ) Starting a long-Term Secondary Relationship.
( ) Starting a Long-Term Primary Relationship.
5.. This relationship won't meet my needs if it doesn't provide or allow for:
( ) Friendship
( ) Cuddling/Smooching
( ) Talking (includes ordinary emailing)
( ) Sexy Emails
( ) Sex
( ) Kinky Sex
( ) Group Sex
( ) Starting a Long-Term Secondary Relationship.
( ) Starting a Long-Term Primary Relationship.
( ) Other - Explain:
6.. If things continue to go well, within a few years I might want to:
( ) Move in together.
( ) Combine economic resources
( ) Have children
( ) Get legally married
( ) Have an open marriage
( ) Purchase a home
( ) Earn a degree
( ) Lifetime Commitment.
( ) Have a multiple (non-legal) marriage.
( ) Other - Explain:
7.. A long-term relationship would not meet my needs unless it provides or allows for:
( ) Moving in together.
( ) Combine economic resources
( ) Having children
( ) Getting legally married
( ) Having an open marriage
( ) Purchasing a home.
( ) Earning a degree.
( ) Lifetime Commitment.
( ) Have a multiple (non-legal) marriage.
( ) Other - Explain:
8.. I am:
( )So het, it's boring.
( )pretty much heterosexual.
( )Bi, with strong het leanings.
( )Bisexual.(Kinsey number between e and pi).
( )Bi, with a stronger attraction for my own sex.
( )pretty much gay/lesbian.
( )exclusively gay.
9.. My sex drive is:
( )out of control/insatiable. A real problem.
( )unusually strong, very hard to resist.
( )healthy, ranging toward high.
( )about average, I guess.
( )a bit below average, usually.
( )something I can keep in check with no problem.
( )so little, I feel like I'm missing out.
10.. For sex, latex is:
( )Required, at least in the beginning,
( )Allowed,
( )Required, in all but my closest relationships.
( )Required, period, unless trying to conceive.
( )Required for some activities but not others.
11.. I'd prefer a Primary relationship:
( )with only one person.
( )with several people, separately.
( )with several people, all together.
12.. I could live with a Primary relationship:
( ) with only one person
( ) with several people, separately
( ) with several people, all together.
13.. I require my primary SOs' [Significant Other's] secondary relationships to be:
( ) people well known to, and close friends with, me.
( ) people I know and who are willing to talk with me.
( ) people who aren't actively hostile to me.
( ) people who are NOT trying to end my relationship.
( ) people my SOs' [Significant Other's] see only with my approval.
( ) people who are likely to become primary partners.
14.. I require my own secondary relationships to be:
( ) people well known to, and close friends with, my primaries.
( ) people known to and who are willing to talk with my primaries.
( ) people who aren't actively hostile to my primaries.
( ) people who are NOT trying to end my primary relationships.
( ) people I see only with my primary SOs' [Significant Other's] approval.
( ) people who are likely to become primary partners.
15.. I have about:
( ) Less than 5
( ) 5-10
( ) 10-15
( ) 15-20
( ) More than 20
hours during the work week that I could spend with a new relationship, not including time spent asleep.
16.. I have about:
( ) Less than 5
( ) 5-10
( ) 10-15
( ) 15-20
( ) 20-30
( ) 30-40
hours during most weekends that I could spend with a new relationship, not including time spent asleep.
17.. Logistical considerations:
( ) I am car-less.
( ) I share a car with someone else.
( ) I am pretty broke right now.
( ) I share a home with someone else.
18.. My phone number is:
( )Good times to call me include:
( )
19.. My email address is:
( )
20.. My religious/spiritual persuasion is:
( )
21.. Gregariousness:
( ) I am a rabid party animal without a leash.
( ) I like to go out and socialize/do stuff, but can be coaxed into staying home.
( ) I'm kind of indolent, but fairly easily coaxed out into the world.
( ) I prefer small gatherings of people known to me.
( ) I'm dead center of the Introversion/Extroversion Scale, or at least I skip rope with the line a lot.
( ) I'm damn sociable for a hermit...sometimes. Mostly I prefer to stay home.
( ) You mean there's a world outside my house? Fancy that!
22.. I am "out" about being poly:
( ) To everyone, and rather vocal about it
( ) To people if it comes up in conversation
( ) With my friends
( ) With my closest non-poly friends
( ) With other polys
( ) With my partners
( ) With my co-workers
( ) With my family
( ) Still in the closet
23.. PDAs [Public Display of Affection] involving secondary partner(s) are acceptable:
( ) Anytime, anywhere
( ) Within the bounds of good taste
( ) With my primary partner(s)
( ) Around other polys
( ) Never
24.. PDAs [Public Display of Affection] involving primary partner(s) are acceptable:
( ) Anytime, anywhere
( ) Within the bounds of good taste
( ) With my secondary partner(s)
( ) Around other polys
( ) Never