Do I Need Relationship Counselling? Self-check from Sana Psychological.

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Are you experiencing dissatisfaction in your relationship or are dissatisfied that you don't have a romantic relationship at this time?* This field is required.

YESNO

2

Do you struggle with communication in relationships?* This field is required.

YESNO

3

Do you struggle with feelings of jealousy or insecurity in relationships?* This field is required.

YESNO

4

Have you considered or had individual relationship or couple's counselling before?* This field is required.

YESNO

5

Are substance use or problem behaviours causing trouble in your relationships?* This field is required.

YESNO

6

Are you experiencing a relationship or multiple relationships as disrespectful?* This field is required.

YESNO

7

Do you have a desire to improve the quality of your relationships?* This field is required.

YESNO

8

Are you interested in learning more about how things like attachment, family of origin, and messaging impact our relationships?* This field is required.

YESNO

9

Would you like to improve sexual intimacy?* This field is required.

YESNO

10

Have you experienced infidelity or a break in trust in a relationship that you are struggling with?* This field is required.

YESNO

11

Do you feel distant from your partner or there is a lot of conflict?* This field is required.

YESNO

12

Have you tried to improve the relationship and things are not changing?* This field is required.

YESNO

13

Are there specific life challenges you would like support on navigating in your relationship (such as parenting, blended families, sexuality, etc.)?* This field is required.

YESNO

14

What is your email? We'll send you more info.* This field is required.You may receive recommendations & free resources from Sana Psyc; you are free to unsubscribe at any time.

example@example.com

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Calculation

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Sorry :( This form is only availble in Canada

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