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Initial Questionnaire

Please fill in this form individually and separately. One for you and one for your spouse. If you're on your own simply complete one. And please complete this by at least 12 hours before your appointment time to give me enough time to prepare for our session. Be aware that only I get the result of this report, not even your partner.

"How often do you use phrases like 'That’s not what I meant!' or 'You’re misunderstanding me!' during conflict?"(Required)
"When my partner gives me feedback, I respond calmly without becoming defensive."(Required)
"My partner and I can discuss sensitive topics without one of us feeling attacked."(Required)
"My partner understands my emotional needs."(Required)
"My partner regularly expresses gratitude for the things I do."(Required)
"My partner knows and respects my boundaries."(Required)
"I feel fulfilled in our intimate relationship."(Required)
"How do you show affection towards your partner?"(Required)
"I feel supported by my partner when dealing with personal challenges or past traumas."(Required)
Do you have a general awareness of unresolve trauma? And are you aware of your spouse's and your own unresolved trauma?(Required)
How does your partner apologize when they make a significant mistake?(Required)
How important is your partner's feeling compared to the conflicting evidence and fact about what is truly happening?(Required)
Do you know your spouse's needs and wants in this relationship?(Required)
Which of the following areas do you think your partner can improve upon?(Required)
Which of the following conflict resolution style do you think your partner can improve upon?(Required)
What do you think of divorce?(Required)
What do you think of couple's therapy(Required)
What do you think of flirting, chatting with strangers of opposite gender in social media, or even the use of pornography?(Required)
When it comes to Finance(Required)
Do you feel valued and prioritized by your partner?(Required)
Do you feel controlled by your partner?(Required)
Do you feel excited about your future together?(Required)
Are you well supported outside your relationship?(Required)
Do you think you understand what your partner's value system is?(Required)

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