The "5-Minute" Relational Capacity Quiz
This 5-minute quiz cuts through the fluff to reveal your true relationship readiness based on your nervous system regulation. Get your personalized blueprint for the Body-Mind Reset you need to achieve authentic confidence.
Name
*
First Name
Last Name
Email
*
example@example.com
Birthdate
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Non-Binary
Other
Prefer Not To Say
Relationship Status
Please Select
Intentionally Single
Casually Dating
Single & Searching
Partnered
Married
Healing
Grieving
Main Life Goal
*
Please Select
Heal from a breakup
Find purpose
Reduce loneliness
Truly love yourself
Build confidence
Improve relationships
Become a high-quality partner
Have more intimacy
Lose weight
Find a partner
Feel more alive
Have more freedom
Other
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Pillar 1: VITALITY (Heal Your Body)
Please rate your level of agreement with the following statements from 1 (Strongly Disagree) to 5 (Strongly Agree).
Physical: I have the high, sustained energy required to be fully present and engaged with the people I love at the end of the day.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Nutritional: I am intentional about how my food and hydration choices impact my mood, patience, and emotional reactivity.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Functional: I manage my daily tasks and schedule effectively so that I don’t bring "chronic exhaustion" into my personal life.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Environmental: I curate my home and digital spaces to be a sanctuary for connection rather than a source of distraction.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Financial: I feel secure and transparent in my finances, ensuring that money stress doesn't act as a barrier to safety or intimacy.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
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Next
Pillar 2: CLARITY (Calm Your Mind)
Please rate your level of agreement with the following statements from 1 (Strongly Disagree) to 5 (Strongly Agree).
Emotional: I can identify and regulate my own "triggers" in real-time before they turn into reactive arguments or withdrawal.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Psychological: I lead my life from a place of "enoughness," ensuring my self-worth isn't dependent on someone else's constant validation.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Intellectual: I prioritize curiosity over "being right," allowing me to seek understanding when others have a different perspective.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Occupational: I have established firm boundaries that prevent my career stress from leaking into my relational "rest" time.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Creative: I have a personal outlet for joy and self-expression that prevents me from relying solely on a partner or social circle for my happiness.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Back
Next
Pillar 3: CONNECTION (Open Your Heart)
Please rate your level of agreement with the following statements from 1 (Strongly Disagree) to 5 (Strongly Agree).
Relational: I navigate conflict by clearly communicating my needs without resorting to attacking, blaming, or shutting down.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Cultural: I understand how my background influences my "relational blueprint" and how I show up for others today.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Social: I have a supportive community outside of my primary relationship that allows my social needs to be met holistically.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Sexual: I feel safe and empowered to prioritize my desires and emotional safety, viewing intimacy as a healthy part of my life.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Spiritual: My daily actions and relationship choices are aligned with a deeper sense of purpose and core values.
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Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Vitality Average Score
Clarity Average Score
Connection Average Score
Submit
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