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Columbia Gorge Cupid Intake Questionnaire

By this stage in life, you know exactly who you are, what you bring to the table, and what you’re finished tolerating. Our matchmaking service doesn't rely on algorithms. We rely on human vetting, deep value-alignment, and lifestyle compatibility. Please answer the following questions with complete authenticity. The more honest you are, the more precise we can be.


Columbia Gorge Cupid operates a highly private, closed registry. The data you provide in this form is strictly confidential and will never be shared publicly, sold, or distributed. It is accessed exclusively by our matching team for the sole purpose of assessing relationship compatibility. This service is free for our launch cohort. In lieu of fees, we invite you to consider making a donation to the Moms on the Rise (MoThR) Scholarship Fund, a scholarship for young moms in Oregon and Washington. This donation is 100% tax deductible.

Section 1: Foundational Logistics & Family Dynamics

Full Name

Date of Birth

Phone Number

Email Address

Current Zip Code

We need to ensure you are a real person. Please share your LinkedIn Profile, Instagram, or Facebook handle.

What is your preferred geographic radius for dating?

What is your preferred geographic radius for dating?

What is the age range you are open to dating?

What is your gender identity?

I am looking to match with candidates who identify as:

I am looking to match with candidates who identify as:

Current Profession & Work Schedule: (e.g., 9-to-5, regular business travel, hybrid/remote flexibility, shift work)

Relationship Status History

Do you have children? (Please list ages and current living/custody arrangements)

What is your relationship like with your co-parent/ex-partner? (e.g., highly collaborative, strictly business, completely separate/independent, no-contact/parallel)

Are you open to dating someone who has (check all that apply):

Are you open to dating someone who has (check all that apply):

Section 2: Lifestyle, Energy, & Daily Rhythms

The 5-to-10 Year Career Horizon: Where are you in your career and lifestyle trajectory?

The 5-to-10 Year Career Horizon: Where are you in your career and lifestyle trajectory?
A
B
C

How do you typically protect and recharge your energy after a demanding week?

How do you typically protect and recharge your energy after a demanding week?
A
B
C

Finances & Lifestyle: How do you approach money in your life right now?

Finances & Lifestyle: How do you approach money in your life right now?
A
B
C

Cleanliness: On a scale of 1 (total minimalist, laid back about clutter) to 10 (meticulously organized, highly neat), where do you fall with regard to cleanliness?

Cleanliness: On a scale of 1 (total minimalist, laid back about clutter) to 10 (meticulously organized, highly neat), where do you fall with regard to cleanliness?

Do you have pets?

Do you have pets?

Are you allergic to pets?

Are you allergic to pets?

Section 3: Core Values, Worldview, & Non-Negotiables

Politics & Worldview: How critical is it that your partner shares your political or social beliefs?

Politics & Worldview: How critical is it that your partner shares your political or social beliefs?
A
B
C

Political Leanings: How would you best describe your political leaning?

Political Leanings: How would you best describe your political leaning?
A
B
C
D
E
F

Spirituality & Religion: What role does faith, spirituality, or religion play in your life, and what do you require from a partner?

Health, Wellness, & Habits: Describe your relationship with physical health, fitness, and diet.

How often do you use/enjoy the following:

Daily
Weekly
Socially
Do not use
Tobacco/ Vaping
Alcohol
Cannabis/ Other

What kind of usage would you accept in a partner?

Daily
Weekly
Socially
Partner usage is a deal-breaker
Tobacco/ Vaping
Alcohol
Cannabis/ Other

Section 4: Emotional Maturity & Relationship Structures

How long has it been since your last major, committed relationship ended?

How long has it been since your last major, committed relationship ended?
A
B
C
D

Reflecting on how your last major relationship concluded, what is your biggest takeaway or personal lesson about yourself?

What is a personal growth goal, hobby, or new perspective you have embraced over the past year that you are proud of?

When entering a new partnership, what is an area of your current independent routine or personal space that you are actively excited to shift or expand to make room for a partner?

A healthy relationship thrives when both partners have full, independent lives. Could you share a bit about your current support network?

For example: Who are the go-to friends, family members, or communities you lean on for advice, celebration, or a listening ear? How do you typically carve out time for your social circle alongside your personal routine?

Conflict Style: When conflict or a misunderstanding naturally arises in a relationship, what is your default communication style?

Conflict Style: When conflict or a misunderstanding naturally arises in a relationship, what is your default communication style?
A
B
C

Rank these five foundational relationship values in order of importance to you (1 being your highest priority, 5 being the lowest):

Rank these five foundational relationship values in order of importance to you (1 being your highest priority, 5 being the lowest):
Use the up and down arrow keys to change the rank.
1
1
1
1
1

Love Languages: How do you prefer to *receive* love? (Rank your top two)

Love Languages: How do you prefer to *receive* love? (Rank your top two)
A
B
C
D
E

Love Languages: How do you best to *give* love? (Rank your top two)

Love Languages: How do you best to *give* love? (Rank your top two)
A
B
C
D
E

Space & Co-habitation: What is your ultimate goal for a long-term relationship structure?

Space & Co-habitation: What is your ultimate goal for a long-term relationship structure?
A
B
C
D

Section 5: The Ideal Match Profile

Describe the energy and "vibe" of your ideal partner in three(ish) words (e.g., Grounded, Wittily Intelligent, Warm).

The "Green Flag": What specific behavior, attitude, or trait instantly makes you feel safe, deeply respected, and attracted to someone?

What are your top THREE absolute, hard dealbreakers? What should we know upfront that will instantly rule a match out?

When it comes to meeting a new match through matchmaking, which statement best describes your current mindset and comfort level?

When it comes to meeting a new match through matchmaking, which statement best describes your current mindset and comfort level?
A
B
C

Attraction and Chemistry: Physical attraction matters, but chemistry often surprises us in person. What are the physical traits, styles, or overall energies that you typically find yourself attracted to? Conversely, are there any physical "hard nos" that we should be aware of to ensure we don't set you up with someone incompatible?

Terms, Safety, and Service Disclaimers

By clicking "Submit" and participating in the Columbia Gorge Cupid matching registry, you explicitly acknowledge and agree to the following terms and conditions:

1. Nature of the Service & No Guarantees: Columbia Gorge Cupid operates as a boutique, curated registry. Completion of the intake form and the 15-minute vetting call does not guarantee acceptance into the dating pool, that you will be matched, that introductions will be made, or that any introduction will result in a successful relationship. Because this is a free entry tier, matches are made entirely at the discretion of the matchmaking team based on compatibility metrics, pool availability, and client alignment. Matchmaking is highly dependent on the volume, demographics, and compatibility criteria of the candidates we receive. We reserve the right to determine eligibility for our registry to protect the quality and safety of our community.

2. Independent Verification & Background Screening: While Columbia Gorge Cupid conducts a mandatory identity verification and preliminary screening via a 15-minute video consultation, we do not perform comprehensive criminal background checks, financial audits, or exhaustive behavioral verification on registry members. You acknowledge that people are capable of misrepresenting themselves, and Columbia Gorge Cupid is not liable for any false statements, omissions, or misrepresentations made by other participants.

3. Personal Safety Responsibility: You are solely and completely responsible for your own safety when interacting with or meeting any match introduced through this service. Columbia Gorge Cupid strongly advises all participants to take standard, appropriate safety precautions before, during, and after determining whether to meet a match in person. This includes, but is not limited to:

- Verifying your match's identity independently before meeting.

- Always meeting in a highly populated, public place for at least the first few dates.

- Providing your own transportation to and from the date (never allowing a match to pick you up at your home).

- Telling a trusted friend or family member exactly where you are going, who you are meeting, and what time you expect to return.

- Keeping your personal financial data, home address, and sensitive workplace details private until a deep level of real-world trust has been established.

4. Limitation of Liability: You agree to release, indemnify, and hold harmless Columbia Gorge Cupid, its founders, matchmakers, and affiliates from any and all claims, damages, losses, liabilities, or injuries (emotional, physical, financial, or otherwise) arising out of or resulting from your participation in the registry, communications with other members, or dates arranged through this service.

5. No Professional Relationship Coaching or Psychological Services: Participants explicitly acknowledge that Columbia Gorge Cupid is a community matching registry operated for interpersonal connection and social entertainment purposes. The founding team and matchmakers are not licensed psychologists, clinical relationship counselors, therapists, or certified behavioral experts. Any insights, compatibility suggestions, or feedback provided during the 15-minute video consultation or subsequent introductions do not constitute professional psychological advice, therapy, or relationship counseling. This service is provided strictly as a curated social introduction tool, and participants are encouraged to seek independent professional guidance for any clinical behavioral or relationship needs.

6. AI & Human Vetting Disclosure: You understand and agree that Columbia Gorge Cupid may use artificial intelligence (AI) data-analysis tools to assist in the initial sorting, parsing, and preliminary compatibility scanning of candidate profiles. However, Columbia Gorge Cupid guarantees that every single match is personally reviewed, vetted, and finalized by a human matchmaker before any introductions are made.

I certify that all information provided in this questionnaire is completely authentic, accurate, and represents my current life status. I understand that providing false or misleading information will result in immediate removal from the registry.

I certify that all information provided in this questionnaire is completely authentic, accurate, and represents my current life status. I understand that providing false or misleading information will result in immediate removal from the registry.

I have read, understood, and agree to the Terms, Safety, and Service Disclaimers above. I acknowledge that this is a free service with no guarantees of matches, and I accept full, personal responsibility for my safety when communicating with or meeting potential matches.

I have read, understood, and agree to the Terms, Safety, and Service Disclaimers above. I acknowledge that this is a free service with no guarantees of matches, and I accept full, personal responsibility for my safety when communicating with or meeting potential matches.

Privacy and Social Media Preference

We love celebrating love and sharing relationship wisdom, but your comfort and privacy are our highest priorities. Please select your preference below.

Please select your preference below.

Please select your preference below.

Because we take vetting seriously, we do not match people based on algorithms alone. The final step to activate your free registry profile is a private, 15-minute video consultation.

This quick face-to-face allows us to verify your identity, get a true sense of your energy and communication style, and ensure the safety of our entire community. Completing the intake questionnaire and video consultation does not guarantee that you will be placed into our dating registry. Once you hit submit, you'll be redirected to Calendly to set up your video consultation.

Note: After booking your spot, keep an eye on your inbox! The link to join the Google Meet video call will be sent to your email, or you can easily launch it straight from your Google Calendar invite. See you soon!