Relationship Advice Question Submission

Your Email Address *
Your email address must be accurate. Should your letter be selected for WTF!? TUESDAY, you will be sent a confirmation email letting you know to listen for a response. However, if the confirmation email bounces back, your letter will be immediately removed from the advice column.
Your Age Group *
Your City/State/Country
Your Gender *
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Your Ethnicity/Race (optional)
 African American/Black 
 Native American or Alaskan 
 European descent/White 
 Asian 
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 Other 
Sometimes the primary race, culture or ethnicity of the advice seeker is relevant to the response, as it impacts upbringing and outlook, as well as values and cultural expectations. This is completely optional, however.
Your astrological sun sign (optional)
If you know your astrological sun sign and wish to share it, please select appropriate selection from drop down list.
Other Party's Gender *
 Female 
  Male 
 N/A 
Other Party's Age Group *
Other Party's astrological sun sign (optional)
If you know your partner's astrological sun sign and wish to share it, please select appropriate selection from drop down list.
Other Party's Ethnicity/Race (optional)
 African American/Black 
 Native American or Alaskan 
 European descent/White 
 Asian 
 Middle Eastern 
 Latin-X/Spanish 
 Native Hawaiian/other Pacific Islander 
 Other 
Sometimes the primary race, culture or ethnicity of the advice seeker is relevant to the response, as it impacts upbringing and outlook, as well as values and cultural expectations. This is completely optional, however.
Type of Advice *
 Free (publication not guaranteed) 
 ($25) Private Email Consultation 
 ($65) Private Phone Consultation 
 ($99) Private Interactive Video Consultation 
Select free for possible publication on the blog and/or WTF!? TUESDAY advice show. For private sessions, choose one of the fee-based options - email, phone or video chat. Payments will be made via PayPal to "survivingdating@gmail.com." Payments are integrated with this form, OR you may pay the appropriate fee on PayPal first, then note the receipt number below. We will contact you to confirm your phone call or video chat consultation appointment.
Summary of Issue *
Sum up the key issue you're facing, or your problem with a brief description /leading question (160 char max)
Type Your Question Here *
DO NOT PUT IN MANUAL RETURNS, just keep typing the field will wrap automatically.Focus on providing only the pertinent information Deb needs to accurately assess your situation and provide a helpful answer. Submissions are limited to a maximum of 500 words.
NEW!! Submit advice questions via video!
Video should be one (1) minute max in length. Use good lighting, a quiet area and enunciate clearly.
Acknowledgement and Release *
 Yes 
By submitting a question, you have given Deborrah Cooper, the Debsterism Channel, SurvivingDating.Com and/or AskHeartBeat.Com all rights in and to said question and response, along with the right to edit, revise, excerpt from, append to, or otherwise publish or broadcast the question, via electronic, visual, audio, broadcast or printed medium for both promotional and/or advertising purposes, or any other commercial or educational purposes deemed suitable for our community and audience, at our sole discretion, in perpetuity. You further acknowledge that: (a) you are asking the personal opinion of an experienced relationship expert for which there is no professional license; (2) you are of legal age in your state or country; (3) you agree fully to the Terms and Conditions herein; (4) you acknowledge and agree to assume any and all risks, liabilities or responsibility for acting or choosing not to act on the opinions stated in any advice columns or broadcasts produced by Deborrah Cooper.

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