Basics

I am satisfied with our overall relationship.
1
2
3
4
5
6
7
8
9
10
I feel heard and understood by my partner.
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2
3
4
5
6
7
8
9
10
Communication between my partner and me is effective.
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2
3
4
5
6
7
8
9
10
I am comfortable discussing challenges and concerns with my partner.
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5
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8
9
10
I feel emotionally connected and supported by my partner.
1
2
3
4
5
6
7
8
9
10
How often do you and your partner spend quality time together?
Daily
Several times a week
Once a week
2-3 times a month
Once a month or less
What aspects of your relationship do you value the most?
What areas of your relationship would you like to improve?
How long have you been in your current relationship?
Less than 6 months
6-12 months
1-3 years
3-5 years
More than 5 years
Prefer not to say
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