Short Relationship Assessment

This short assessment looks at how well the two of you attune/connect to each other emotionally as well as how you are aligned in different areas of your life.

It is our hope that this assessment can open communication while understanding each other more intimately. At the end of the assessment we will share some resources to stimulate growth in areas that you may want to improve.

Instructions: It is best to take this assessment quickly and not “over think” the questions. Each partner takes it separately, without influencing the other.

Score the following questions on this Relationship Assessment on a scale from 1 to 5. Some questions have examples of what 1 through 5 could look like.

1) I don’t agree at all with this statement. 0-15%

2) I mostly disagree with this statement. 20-40%

3) I’m not sure either way with this statement 40-60%

4) I mostly agree with the statement. 60-80%.

5) I am in total agreement with this statement. 85-100%

First and Last Name *

Best Email Address To Send You The Results *

If your partner is taking this assessment also, please provide their name: *

Which counselor have you been assigned to? *

Assessment Section 1 - Emotional Connection

1) I feel my partner is there for me in whatever the situation is, I can count on them. *

1) I don’t agree at all with this statement. 0-15%

2) I mostly disagree with this statement. 20-40%

3) I’m not sure either way with this statement 40-60%

4) I mostly agree with the statement. 60-80%.

5) I am in total agreement with this statement. 85-100%

2) I feel I matter to my partner more than anyone or anything on earth. *

1) I don’t agree at all with this statement. 0-15%

2) I mostly disagree with this statement. 20-40%

3) I’m not sure either way with this statement 40-60%

4) I mostly agree with the statement. 60-80%.

5) I am in total agreement with this statement. 85-100%

3) I feel my partner will come when I when I need them to, in any situation.

1) I don’t agree at all with this statement. 0-15%

2) I mostly disagree with this statement. 20-40%

3) I’m not sure either way with this statement 40-60%

4) I mostly agree with the statement. 60-80%.

5) I am in total agreement with this statement. 85-100%

4) I love talking and sharing about what is going on in each other’s lives. I can sit and share for hours about the past and looking to the future. They are my favorite person to be with.

1) I don’t agree at all with this statement. 0-15%

2) I mostly disagree with this statement. 20-40%

3) I’m not sure either way with this statement 40-60%

4) I mostly agree with the statement. 60-80%.

5) I am in total agreement with this statement. 85-100%

Assessment Section 2 - Relational Connection

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