Confidential Questionnaire

Fill out the form below and one of our representatives will contact you shortly! Privacy is of the utmost importance at Vegas Valley Introductions; therefore, your information will never be shared or distributed in any way. We look forward to hearing from you and guiding you on your journey to finding real, lasting love! You may also call us at 702-701-7770 to schedule a consultation.


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1) I love having people around me:

2) I would like a partner who is the life of the party:

3) I am a very affectionate person and long for the same:

4) I set goals in my life and strive to achieve them:

5) I am happiest when in love and don't like being alone:

6) I am open minded and wear my heart on my sleeve:

7) I am very emotional about love:

8) Respect is very important in a relationship:

9) It is important that my mate and I are on the same intellectual level:

10) It's important that my mate and I share the same cultural, ethnic & religious backgrounds:

Which of the following have you utilized to meet people? (check all that apply):

Which of the following make it a challenge to meet people? (check all that apply):

Let us know if you have any other comments:

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