Relationship Assessment for Couples 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.*Not at allSomewhatMostlyCompletelyMy vision for life is supported in this relationship.*Not at allSomewhatMostlyCompletelyMy life purpose and mission are supported in this relationship.*Not at allSomewhatMostlyCompletelyI am willing to live the rest of my life with everything exactly the way it is in this relationship.*Not at allSomewhatMostlyCompletelyI am not settling for less than what I really want in this relationship.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding money.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding future plans.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding children and family.*Not at allSomewhatMostlyCompletelyI trust my partner to be successfully faithful.*Not at allSomewhatMostlyCompletelyI trust my partner with our/my money.*Not at allSomewhatMostlyCompletelyI trust my partner to be honest with me about everything.*Not at allSomewhatMostlyCompletelyI trust my partner to keep agreements in our relationship.*Not at allSomewhatMostlyCompletelyI can see myself growing old and happy in this relationship.*Not at allSomewhatMostlyCompletelyI feel physically safe in this relationship.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding lifestyle.*Not at allSomewhatMostlyCompletelyWe have successfully adjusted to having different food preferences and eating habits.*Not at allSomewhatMostlyCompletelyI am satisfied with our health habits and practices.*Not at allSomewhatMostlyCompletelyI am satisfied with our grooming and hygiene habits and practices.*Not at allSomewhatMostlyCompletelyI am satisfied with our hobbies, physical and leisure activities.*Not at allSomewhatMostlyCompletelyI am satisfied with our level of desire for travel and adventure.*Not at allSomewhatMostlyCompletelyWe are well matched in our preferences to stay home and have quiet times.*Not at allSomewhatMostlyCompletelyWe travel well together.*Not at allSomewhatMostlyCompletelyI am supported to pursue my own interests/activities in this relationship.*Not at allSomewhatMostlyCompletelyOur families support our relationship.*Not at allSomewhatMostlyCompletelyOur friends support our relationship.*Not at allSomewhatMostlyCompletelyI am satisfied with our preferences for socializing with friends and family.*Not at allSomewhatMostlyCompletelyWe both have individual support systems.*Not at allSomewhatMostlyCompletelyWe seek support when we need it.*Not at allSomewhatMostlyCompletelyI feel loved in this relationship.*Not at allSomewhatMostlyCompletelyI feel good about myself in this relationship.*Not at allSomewhatMostlyCompletelyThis relationship brings out the best in me.*Not at allSomewhatMostlyCompletelyI feel emotionally safe in this relationship.*Not at allSomewhatMostlyCompletelyI feel able to be myself in this relationship.*Not at allSomewhatMostlyCompletelyI feel respected for who I am in this relationship.*Not at allSomewhatMostlyCompletelyWe have equal levels of give and take in this relationship.*Not at allSomewhatMostlyCompletelyI have fun and laugh in this relationship.*Not at allSomewhatMostlyCompletelyThis relationship feels equal on all levels.*Not at allSomewhatMostlyCompletelyThis relationship feels equal on all levels.*Not at allSomewhatMostlyCompletelyWe enjoy small moments of connection each day no matter how busy we are.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding religious and/or spiritual beliefs and practices.*Not at allSomewhatMostlyCompletelyI am satisfied with how we live our values in our life together.*Not at allSomewhatMostlyCompletelyI am satisfied with how we plan to make a difference in the world.*Not at allSomewhatMostlyCompletelyWe support each other's hopes, dreams and aspirations.*Not at allSomewhatMostlyCompletelyWe recognize and support each other's "essence" in times of stress.*Not at allSomewhatMostlyCompletelyOur communication is effective*Not at allSomewhatMostlyCompletelyWe manage our differences positively and without conflict.*Not at allSomewhatMostlyCompletelyI am able to be totally honest in this relationship.*Not at allSomewhatMostlyCompletelyWe handle stress effectively together.*Not at allSomewhatMostlyCompletelyWe handle differences and conflict effectively without "fight" or "flight."*Not at allSomewhatMostlyCompletelyWe are able to soothe ourselves and each other during tense situations.*Not at allSomewhatMostlyCompletelyWe are able to live positively with our unresolvable differences.*Not at allSomewhatMostlyCompletelyWe respect each other's feelings and reactions during a conflict.*Not at allSomewhatMostlyCompletelyWe regularly discuss small frustrations and irritations so that they do not get larger.*Not at allSomewhatMostlyCompletelyWe try to make things better during or after a conflict.*Not at allSomewhatMostlyCompletelyWe forgive each other and don't hold on to resentments.*Not at allSomewhatMostlyCompletelyWe are in alignment about pets*Not at allSomewhatMostlyCompletelyWe are in alignment about how to handle kids.*Not at allSomewhatMostlyCompletelyWe are in agreement about who does what around your home whether it is "pink" or "blue" jobs.*Not at allSomewhatMostlyCompletelyWe are in alignment regarding our level of organization and neatness around our home.*Not at allSomewhatMostlyCompletelyWe share equally in caring for our home.*Not at allSomewhatMostlyCompletelyI experience strong chemistry in this relationship.*Not at allSomewhatMostlyCompletelyI experience passion in this relationship.*Not at allSomewhatMostlyCompletelyI experience romance in this relationship.*Not at allSomewhatMostlyCompletelyI find my partner very attractive.*Not at allSomewhatMostlyCompletelyI get turned on with my partner.*Not at allSomewhatMostlyCompletelyI know what turns on my partner.*Not at allSomewhatMostlyCompletelyWe talk about our sexual preferences.*Not at allSomewhatMostlyCompletelyI am fulfiled sexually in this relationship.*Not at allSomewhatMostlyCompletelyI am satisfied intelluctually in this relationship.*Not at allSomewhatMostlyCompletelyI am satisfied emotionally in this relationship.*Not at allSomewhatMostlyCompletelyI am satisfied with the level of maturity in this relationship.*Not at allSomewhatMostlyCompletelyWe know and accept each other's quirks.*Not at allSomewhatMostlyCompletelyWe intimately know each other's likes and dislikes, hopes and dreams and have created a vision for our life together.*Not at allSomewhatMostlyCompletelyWe stimulate positive growth and learning for each other.*Not at allSomewhatMostlyCompletelyWe stimulate positive growth and learning for each other.*Not at allSomewhatMostlyCompletelyI would like to be notified of any upcoming couples workshop or retreat.*YesNoI would like a free strategy session to go over my results with a Professional Relationship Coach.*YesNoAny further comments you would like to add?Name* First Last Email* *Used by permission from the Relationship Coaching Insitute.
