Statistic Evaluation of Cousin Couples

1. Please indicate the country you are from

2. Please indicate which state you live in. (If outside the US and Canada, select N/A)

3. Relationship Status
I am married to my cousin
I am engaged to my cousin
I am dating my cousin
I have a crush on my cousin
We are in love, but one or both of us is currently committed to another person

4. Kinship status
We are first cousins
We are first cousins once removed
We are second cousins
We are third cousins
We don't know exactly HOW we are related
We are double first cousins
We are first cousins descending from identical twins.

5. Children of this relationship
We are unable to have children together
We have children together
We plan to have children together
We do not desire to have children together

6. Children from previous relationships
Neither of us have children from previous relationships
The children know and accept our relationship
The children do not accept our relationship
The children are unaware of our relationship

7. Children's health (check all that apply)
We have no children
All our children were born and remain healthy
One or more children (born into a cousin relationship) have genetic problems
One or more children (NOT born to a cousin relationship) have genetic problems
All our children are of average, or above average intelligence
One or more children (born into a cousin relationship) have a mental disability
One or more children (NOT born to a cousin relationship) have a mental disability

8. If you have children with disabilities, please specify the nature of the problem(s)

9. Due to ethnic origin, may your children be at greater risk for certain genetic disorders? (i.e. Tay Sachs, Sickle Cell, etc.)
No
Yes
Don't Know

10. Is there a history of the following categories of genetic disease or disabity in your families? (Please refer to our genetic comparison page for definitions)
None
Autosomal Recessive
Autosomal Dominant
X-Linked
Multi-factoral (environmentally influenced)

11. If yes, please specify

12. Please indicate your average household income

13. Please indicate your level of education
High School, equivalent, or still student
College, Tech or Trade School

15. Please indicate your spouse or significant other's level of education if applicable
High School, equivalent, or still student
College, Tech or Trade School

16. Please list any degrees held by you or your partner (Not necessary to distinguish whose is whose)

17. Please indicate your occupation

18. Please indicate your significant other's occupation (if applicable)

19. Please indicate the religious preference of you, and your partner, if applicable
Christian (most denominations) or Jewish
Catholic
Mormon
JW
Eastern Orthodox
Islam
Hindu
Buddhist
Atheist or Agnostic
Other

20. How did you hear about C.U.D.D.L.E. International?

 



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