Fill out this simple questionnaire
and press submit for a free evaluation.
Also, you will instantly
receive a FREE copy of 10 Practices for Joy, Happiness and
Contentment. |
| I am
a |
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Briefly
describe the problem areas of your relationship. |
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| Age |
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| Marital Status |
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| Please
answer these questions with regard to your primary relationship.
If you are not in a marriage or intimate relationship, please
answer in regard to your closest family relationship or friendship.
Use the pulldown menus: 0-Never, 1-Seldom, 2-Sometimes, 3-Usually,
4-Always. |
| 1. I can easily ask
for what I want in my relationships. |
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7.
I take full responsibility for my part in every upset and
misunderstanding. |
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| 2. I am comfortable
talking about my feelings, or expressing my emotions. |
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8. I understand that
our relationship problems are equally contributed to and are
not just the other person's fault. |
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| 3. I enjoy nurturing
and expressing my affection to my mate. |
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9. My partner and
I take time regularly for play, laughter and passion. |
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| 4. Is it easy for
me to receive acknowledgement, support and attention from
my mate. |
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10. I respect my
partner's feelings and ideas, even when they differ from mine. |
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| 5. I take the time
to communicate my hopes, dreams & goals with my mate and
plan ways to make them happen. |
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11. I feel supported
and honored in my primary relationship. |
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| 6. When I have an
upset or mis-understanding, it is important for me to communicate
until we reach resolution & understanding. |
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12. I support and
respect my mate and express it easily and regularly. |
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Please Total Your Score
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| First Name |
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| Email |
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Please Press Submit.
THANK YOU.
PLUS, you will immediately receive your BONUS of 10 Practices
for joy, contentment & well-being.
However, if these questions have sparked greater curiosity
and interest in discovering more about yourself & your
relationships, PLEASE DO THIS:
- Make a list of everything in your
life that is not exactly the way you want it.
Click
Here to E mail me the list and any questions or comments.
I will contact
you soon with how I believe I can support you with getting
what you want in your life.
Blessings and Aloha,
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