Discover US

Discover US

Do we have a healthy, secure and connected relationship?
Name*

First NameLast Name
Email*
example@example.com
1 - Emotional Connection/Support

How "connected" do I feel?
1. I feel emotionally safe. I feel comfortable expressing my TRUE thoughts and feelings*

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0 is False - I don't feel safe. It never goes well. , 5 is True - I feel very safe. I feel accepted!
2. My partner is a good listener and shows genuine interest in our relationship*

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0 is False - They seem distant and disconnected. , 5 is True - My partner is "all in".
3. My partner supports my growth, goals and dreams without jealousy. They encourage my passions and interests. *

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0 is False - They are not supportive at all. , 5 is True - They are very supportive.
4. I feel respected, valued and appreciated in the relationship. *

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0 is False - I don't get much respect. , 5 is True - I feel very appreciated and valued.
Emotional Connection/Support Total
2 - Trust & Reliability

Can I be me?
5. I can trust my partner to be honest, faithful and reliable. *

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0 is False - No, I don't really trust them. , 5 is True - Yes, they are extremely trustworthy.
6. My partner follows through with their commitments and promises. *

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0 is False - They rarely if ever follow through. , 5 is True - They consistently keep their word and do what they say they will do.
7. I feel comfortable to share my vulnerabilities without fear of judgment or rejection *

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0 is False - I can't share at all. I will be judged every time. , 5 is True - I feel comfortable to share whatever I need to share.
8. I can relax and be my authentic self in the relationship. I don't walk on eggshells. *

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0 is False - I hide who i really am. I juts want to keep the peace. , 5 is True - I am my true and authentic self!
Trust & Reliability Total
3 - Compatibility & Communication

Are we compatible?
9. We share similar Core Values, beliefs and long-term visions for life *

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0 is False - We are very different people., 5 is True - Yes, we agree on almost everything!
10. We have healthy and open communication. We are comfortable having hard discussions. *

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0 is False - We have trouble communicating, 5 is True - We can talk easily about anything.
11. We have fun together and enjoy each others company *

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0 is False - We don't have a lot of fun. , 5 is True - We have fun no matter what we are doing.
12. We contribute equally to the relationship both emotionally and practically. *

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0 is False - It doesn't feel all that equal., 5 is True - Yes, we both contribute equally.
Compatibility & Communication Total
4 - Emotional & Physical Intimacy

Signs of true intimacy.
13. I feel emotionally connected to to my partner, not just physically. *

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0 is False - I am not connected at all. , 5 is True - I feel very connected!
14. Our overall intimacy is fulfilling and mutual. (physical, emotional and intellectual) *

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0 is False - I am not fulfilled at all. , 5 is True - I feel very fulfilled!
15. I feel safe expressing my needs and my partner normally meets my needs. *

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0 is False - My needs are not a factor in this relationship., 5 is True - I feel my needs are usually met.
16. I am genuinely happy and at peace in this relationship, most of the time. *

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0 is False - I feel overwhelmed and anxious most of the time. , 5 is True - I am at peace most of the time.
Emotional & Physical Intimacy Total
5 - Conflict / Disruptions

Text
17. We work through conflict with understanding and kindness rather than blame or avoidance.*

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0 is False - We have problems dealing with conflict fairly. , 5 is True - We deal with conflict fairly and effectively.
18. We are both good at taking responsibility for our actions instead of making excuses and shifting blame. *

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0 is False - There is a lot of defensiveness and excuses. , 5 is True - We both are good at accepting responsibility.
19. We respect each others differences without trying to control or change one another. *

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0 is False - We consistently point out flaws and issues with each other. , 5 is True - We both feel accepted for who we are.
20. If nothing ever changes, I would still want to be in this relationship in 5 years. *

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0 is False - I feel that that changes are needed. , 5 is True - I am content with things just as they are.
Conflict / Disruptions Total
My Quick Discover US Assessment Total
What does my total mean?

39 or less - You likely feel an extreme disconnection in your relationship, and as confusing as it can sometimes feel, there is a path forward. Discover US can certainly provide some valuable input as to what is really happening and help you to make decisions about next steps.

40-59 - Your relationship is not the source of peace and connection that you were hoping. If you are both willing to make the commitment, there are lots of ways to grow and connect! Discover US will identify the areas of concern and get you moving in the right direction.

60-79 - You liklely have some areas of connection and some areas that could use real improvement. Discover US will give you a clear path forward!

80 or more - It appears that you have a healthy and connected relationship. Discover US and ACP can take you to yet another level!
I would be interested in learning more about how ACP / DiscoverUS can help us to explore healthy relationship skills and improve our relationship*

Yes (We can set up a time to meet on Zoom to discuss the options)Maybe (We will send you an email to start a dialogue to see what might be possible.)Not sure (We will send you a list of our *AMBASSADORS* that you can contact for more information.)No (We will wait for you to contact us when you are ready!)
(Note - Ambassadors are current and former clients that have achieved significant growth through ACP and DiscoverME and have asked to provide support and information to those of you who may have questions!)
Should be Empty:

1 - Emotional Connection/Support

2 - Trust & Reliability

3 - Compatibility & Communication

4 - Emotional & Physical Intimacy

5 - Conflict / Disruptions