2. Family & Religion

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Parents:

○ Biological Mother

○ Biological Father

○ Step-mother

○ Step-father

○ Adoptive Mother

○ Adoptive Father

○ Others: __________



Siblings:

○ Biological Brother (No._____)

○ Biological Sister (No._____)

○ Step-brother (No._____)

○ Step-sister (No._____)

○ Adoptive Brother (No._____)

○ Adoptive Sister (No._____)

○ Others: __________



Relationship Status:

○ Single

○ In a relationship

○ It's complicated

○ Engaged

○ Married

○ Divorced

○ Widowed



Children:

○ Biological Son (No._____)

○ Biological Daughter (No._____)

○ Step-son (No._____)

○ Step-daughter (No._____)

○ Adoptive son (No._____)

○ Adoptive Daughter (No._____)

○ Others: __________



Other Relatives:

○ Aunt (No._____)

○ Uncle (No._____)

○ Niece (No._____)

○ Nephew (No._____)

○ Grandmother (No._____)

○ Grandfather (No._____)

○ Great-grandmother and beyond (No._____)

○ Great-grandfather and beyond (No._____)

○ Others: ___________



Pets:

○ Dog(s) (No._____)

○ Cat(s) (No._____)

○ Bird(s) (No._____)

○ Hamster(s) (No._____)

○ Turtle(s) (No._____)



Ethnicity:

○ American Indian or Alaska Native

○ Asian

○ Black or African American

○ Hispanic or Latino

○ Native Hawaiian or Other Pacific Islander

○ White

○ Other: __________



Religion:

○ Christianity

○ Buddhism

○ Islam

○ Hinduism

○ Other: __________



Superstition:

○ Friday the 13th

○ Find a penny, pick it up

○ No umbrellas indoors

○ Don't walk under that ladder

○ Cross your fingers

○ Others: __________



Social Life:

○ Non-existent

○ Limited

○ It's there

○ Active

○ 24/7



Social Class:

○ Very low

○ Low

○ Middle-low

○ Middle

○ Middle-high

○ High

○ Very High



Name of:

○ Significant Other(s): _______________________________

○ Friends: _______________________________

○ Enemies: _______________________________

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