Relationship Self-Check
When was the last time you checked in with yourself? How are your relationships impacting your life? Take a quick survey to go deeper than surface level thoughts!
Name
First Name
Last Name
Email
example@example.com
Age Range
Do you feel satisfied with the relationships in your life?
Rows
Agree
Strongly Agree
Neutral
I feel close to my partner.
My partner cares about me.
I feel close to my family.
I consider myself happy in my relationships
My friends and family support me
Please choose true or false according to the following situations;
Rows
True
False
Home life feels comfortable.
There is a sense of peace in my life.
I am not able to function well in my own.
Negative events keep happening and I don't know how to respond.
I always have to adapt to changing circumstances.
Arguments with others seem to come up out of nowhere.
I brings up issues abruptly or with poor timing.
I find other people's negativity unsettling.
I look forward to reunions with my partner at the end of each day.
I often get blamed for issues.
I am ready to work on my part
Are you comfortable creating new relationships (intimate or professional)?
Please Select
Yes
No
Sometimes
Has self-love been a current issue in your life?
Please Select
Yes
No
Sometimes
What techniques have you used in the past to work on your relationships?
Have you reached a breaking point in your relationships? If so, what was it and are you ready to try something different?
Submit
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