SACRED CEREMONY FOR COUPLES Questionnaire Form

SACRED CEREMONY FOR COUPLES Questionnaire Form

Thank you for taking the time to answer these questions.
Name

First NameLast Name
1. What are your personal intentions and goals for participating in this Sacred Medicine Ceremony for Couples?*
2. Are you fully committed to participating in the entire ceremony, regardless of the challenges that may arise?*

YesNo
3. Are you willing to listen to each other's perspectives with the intention of fully understanding your partner's views, emotions, expressions, and desires?*

YesNo
4. Are you willing to speak your truth, express your emotions, perceptions, and desires for this relationship and for yourself?*

YesNo
5. Are you fully aware of the depth and intensity of the work you are about to undertake in this ceremony?*

YesNo
6. Have you discussed and agreed upon the importance of mutual respect, openness, and vulnerability during the ceremony?*

YesNoWe have not discussed or agreed but are willing to be in ceremony together to enhance our relationship and create a more harmonious connection.
7. Are you emotionally ready to confront any unresolved issues or past traumas that may surface during the ceremony?*

YesNoI am not sure if I am emotionally ready to confront, but I am open to the opportunity to grow inward and with my partner.
8. Are you committed to using the insights gained from the ceremony to heal, enhance, and improve your relationship?*

YesNo
9. How do you plan to support each other emotionally throughout the ceremony and beyond?*

I will be open to listen with the intention of understanding my partners perceptions, view and desiresI am going to pay attention to my own words, body language, and attitudes that may have a negative imprint and correct my reactionsI will do my sincere very best to be part of the solution and not the problem.All of the above!Other
10. What particular aspect(s) of yourself you think need attention?*
11. What do you think makes a good relationship?*
12. How easy it is to maintain harmony in your home?*
13. How often do you talk about the importance of the harmony and wellbeing of your relationship?*
14. What do you admire most about your relationship?*

15. Please rank what you consider is important to you in your relationship?

	1 - Not Important	2 -little important	3 - Maybe	4 - Important	5 - Very Important
Deep Connection (Sex, Intimacy)
Security (feeling safe)
Fun time together alone
Responsibilities shared
Harmony in the home
My Partners Happiness!
Financial stability
Loyalty
Understanding
Space to be myself without judgement
Respect of point of views and disagreements
Spiritual Connection together and individually
Assigning shared tasks to keep the home clean and stable

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