Relational Satisfaction Index

Name*

First NameLast Name

Total Score

Who is your therapist?*

	Extremely Unhappy(0)	Fairly Unhappy(1)	A Little Unhappy(2)	Happy(3)	Very Happy(4)	Extremely Happy(5)	Perfect(6)
1. Please indicate the degree of happiness, all things considered, of your relationship.

Most people have disagreements in their relationships. Please indicate below the approximate extent of agreement or disagreement between you and your partner for each item on the following list. *

	Always Agree(5)	Almost Always Agree(4)	Occasionally Disagree(3)	Frequently Disagree(2)	Almost Always Disagree(1)	Always Disagree(0)
2. Amount of time spent together
3. Making major decisions
4. Demonstrations of affection

	All the Time(5)	Most of the Time(4)	More Often Than Not(3)	Occasionally(2)	Rarely(1)	Never(0)
5. In general, how often do you think that things between you and your partner are going well?

	All the Time(0)	Most of the Time(1)	More Often Than Not(2)	Occasionally(3)	Rarely(4)	Never(5)
6. How often do you wish you hadn't gotten into this relationship?

	Not at all true(0)	A little true(1)	Somewhat true(2)	Mostly True(3)	Almost completely true(4)	Completely true(5)
7. I still feel a strong connection with my partner.
8. If I had my life to live over, I would marry (or live with/date) the same person.
9. Our relationship is strong.

	Not at all true(5)	A little true(4)	Somewhat true(3)	Mostly True(2)	Almost completely true(1)	Completely true(0)
10. I sometimes wonder if there is someone else out there for me.

	Not at all(0)	A little(1)	Somewhat(2)	Mostly(3)	Almost completely(4)	Completely(5)
19. How rewarding is your relationship with your partner?
20. How well does your partner meet your needs?
21. To what extent has your relationship met your original expectations?
22. In general, how satisfied are you with your relationship?

	Never (0)	Less than once a month (1)	Once or twice a month (2)	Once or twice a week (3)	Once a day (4)	More often (5)
24. Do you enjoy your partner's company?
25. How often do you and your partner have fun together?

	Not at all true(0)	A little true(1)	Somewhat true(2)	Mostly True(3)	Almost completely true(4)	Completely true(5)
11. My relationship with my partner makes me happy.
12. I have a warm and comfortable relationship with my partner.
13. I can't imagine ending my relationship with my partner.
14. I feel that I can confide in my partner about virtually anything.

	Not at all true(0)	A little true(1)	Somewhat true(2)	Mostly True(3)	Almost completely true(4)	Completely true(5)
16. For me, my partner is the perfect romantic partner.
17. I really feel like a part of a team with my partner.
18. I cannot imagine another person making me as happy as my partner does.