Relationship Assessment

What’s Really Happening in Your Relationship? (Take This 2-Minute Test)

Dr. Frantz Lamour, LMHCLicensed Mental Health CounselorMarriage & Family Counseling Specialist📞 (561) 827-2760📧 lovecounseling@lovecounselingcenter.com
Welcome to Love Counseling Center.

Take this free, quick assessment to understand what’s working, what’s missing, and exactly what to do next in your relationship.

All information is confidential and used only for clinical purposes.
Full Name*

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Phone Number*
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Relationship Assessment

Purpose: This section helps us understand the strengths and challenges in your relationship so we can create a focused and effective treatment plan. Please answer honestly. There are no right or wrong answers.
SCALE DEFINITIONS
Emotional Safety (1–5): Do you feel safe being open, honest, and vulnerable with your partner? Low (1–2): Fear of judgment, criticism, or emotional harm. Moderate (3): Sometimes safe, sometimes guarded. High (4–5): Can express yourself freely

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1 is Not safe at all, 5 is Completely safe
Communication (1–5): How well do you and your partner express and understand each other? Low (1–2): Frequent misunderstandings, arguments escalate quickly. Moderate (3): Some clarity, but still tension or breakdowns. High (4-5): Clear, respectful, and productive conversations

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1 is Very poor communication, 5 is Clear and effective communication
Trust (1–5): How much do you trust your partner emotionally and behaviorally? Low (1–3): Suspicion, insecurity, past betrayal impacting present. Moderate (4–6): Trust exists but is fragile or inconsistent. High (4–5): Strong confidence in your partner’s integrity*

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1 is No trust, 5 is Complete trust
Emotional Connection (1–5): How emotionally connected do you feel to your partner?Low (1–3): Distant, disconnected, or emotionally alone. (3): Some connection, but inconsistent closeness. High (4-5): Deep bond, closeness, and emotional intimacy.

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1 is Disconnected, 5 is Deeply connected
Feel Heard (1–5): Do you feel your partner truly listens and understands you? Low (1–2): Frequently interrupted, dismissed, or misunderstood. Moderate (3): Sometimes heard, but still feel overlooked. High (4–5): Feel listened to, understood, and validated*

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1 is Not heard at all, 5 is Fully heard and understood
Rarely (once a month or less)Occasionally (a few times a month)WeeklySeveral times per weekDaily
Pursue–Withdraw: One pushes to talk, the other shuts downYelling/Escalation: Arguments become loud and intenseSilence/Avoidance: Issues are ignored or never resolvedBlame/Defensiveness: Focus on who is wrong instead of solvingCalm but Unresolved: Conversations happen but don’t lead to change
Total Relationship Score:
If you have any questions, please contact:

📞 (561) 827-2760
📧 lovecounseling@lovecounselingcenter.com

We look forward to supporting you.
© 2026 Dr. Frantz Lamour, LMHC. All rights reserved. This assessment and its contents are the intellectual property of Love Counseling Center and may not be reproduced or distributed without permission.
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What’s Really Happening in Your Relationship? (Take This 2-Minute Test)

Relationship Assessment

SCALE DEFINITIONS