Couples Relationship Assessment

Couples Relationship Assessment

Couples Relationship Assessment

This confidential online 77-question assessment will provide a comprehensive review of the important areas of your relationship along with general recommendations for discussion and goal-setting with your partner. Please fill out individually. This assessment should take you between 15-20 minutes to complete.
My non-negotiable requirements are met in this relationship.(Required)
My vision for life is supported in this relationship.(Required)
My life purpose and mission are supported in this relationship.(Required)
I am willing to live the rest of my life with everything exactly the way it is in this relationship.(Required)
I am not settling for less than what I really want in this relationship.(Required)
We are in alignment regarding money.(Required)
We are in alignment regarding future plans.(Required)
We are in alignment regarding children and family.(Required)
I trust my partner to be successfully faithful.(Required)
I trust my partner with our/my money.(Required)
I trust my partner to be honest with me about everything.(Required)
I trust my partner to keep agreements in our relationship.(Required)
I can see myself growing old and happy in this relationship.(Required)
I feel physically safe in this relationship.(Required)
We are in alignment regarding lifestyle.(Required)
We have successfully adjusted to having different food preferences and eating habits.(Required)
I am satisfied with our health habits and practices.(Required)
I am satisfied with our grooming and hygiene habits and practices.(Required)
I am satisfied with our hobbies, physical and leisure activities.(Required)
I am satisfied with our level of desire for travel and adventure.(Required)
We are well matched in our preferences to stay home and have quiet times.(Required)
We travel well together.(Required)
I am supported to pursue my own interests/activities in this relationship.(Required)
Our families support our relationship.(Required)
Our friends support our relationship.(Required)
I am satisfied with our preferences for socializing with friends and family.(Required)
We both have individual support systems.(Required)
We seek support when we need it.(Required)
I feel loved in this relationship.(Required)
I feel good about myself in this relationship.(Required)
This relationship brings out the best in me.(Required)
I feel emotionally safe in this relationship.(Required)
I feel able to be myself in this relationship.(Required)
I feel respected for who I am in this relationship.(Required)
We have equal levels of give and take in this relationship.(Required)
I have fun and laugh in this relationship.(Required)
This relationship feels equal on all levels.(Required)
We enjoy small moments of connection each day no matter how busy we are.(Required)
We are in alignment regarding religious and/or spiritual beliefs and practices.(Required)
I am satisfied with how we live our values in our life together.(Required)
I am satisfied with how we plan to make a difference in the world.(Required)
We support each other's hopes, dreams and aspirations.(Required)
We recognize and support each other's "essence" in times of stress.(Required)
Our communication is effective(Required)
We manage our differences positively and without conflict.(Required)
I am able to be totally honest in this relationship.(Required)
We handle stress effectively together.(Required)
We handle differences and conflict effectively without "fight" or "flight."(Required)
We are able to soothe ourselves and each other during tense situations.(Required)
We are able to live positively with our unresolvable differences.(Required)
We respect each other's feelings and reactions during a conflict.(Required)
We regularly discuss small frustrations and irritations so that they do not get larger.(Required)
We try to make things better during or after a conflict.(Required)
We forgive each other and don't hold on to resentments.(Required)
We are in alignment about pets(Required)
We are in alignment about how to handle kids.(Required)
We are in agreement about who does what around your home whether it is "pink" or "blue" jobs.(Required)
We are in alignment regarding our level of organization and neatness around our home.(Required)
We share equally in caring for our home.(Required)
I experience strong chemistry in this relationship.(Required)
I experience passion in this relationship.(Required)
I experience romance in this relationship.(Required)
I find my partner very attractive.(Required)
I get turned on with my partner.(Required)
I know what turns on my partner.(Required)
We talk about our sexual preferences.(Required)
I am fulfiled sexually in this relationship.(Required)
I am satisfied intelluctually in this relationship.(Required)
I am satisfied emotionally in this relationship.(Required)
I am satisfied with the level of maturity in this relationship.(Required)
We know and accept each other's quirks.(Required)
We intimately know each other's likes and dislikes, hopes and dreams and have created a vision for our life together.(Required)
We stimulate positive growth and learning for each other.(Required)
Name(Required)