Relationship multi-factor combined scale Skip this if you are not in a long-term relationship and haven’t ended one recently. Relationship Assessments Email (enter same email each time so the system combines them properly)(Required) For this section. Most people have disagreements in their relationships. Please indicate below the approximate extent of agreement or disagreement between you and your partner for each item on the following list.Handling family finances(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Religion and way of life matters(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Demonstrations of affection(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Sex relations(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Ways of dealing with parents or in-laws(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Parenting styles and decisions(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Amount of time spent together(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Making major decisions(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Leisure time interests and activities(Required) Always Agree Almost Always Agree Occasionally Disagree Frequently Disagree Almost Always Disagree Always Disagree Please answer the followingAssuming the middle point "happy" represents the happiness level of the average relationship, how happy is your relationship?(Required) Extremely Unhappy Fairly Unhappy A Little Unhappy Happy Very Happy Extremely Happy Perfect When's the last time you had sexual activity with your partner?(Required) Within the last week Within the last month More than a month but less than four months Between four months and a year ago More than a year ago How true is this statement. If I had a life "do over", I would marry my partner again.(Required) Very True More True than False Neutral More False than True Very False How true is this statement. I am determined to make my relationship succeed, and I will go to any length to make that happen.(Required) Very True More True than False Neutral More False than True Very False How often would you say the following events occur between you and your partner?You kiss -- even if it's a peck on the cheek(Required) Every Day Almost Every Day Occasionally Rarely Never Have a stimulating exchange of ideas(Required) Never Less than once a month Once or twice a month Once a day More often Laugh together(Required) Never Less than once a month Once or twice a month Once a day More often Calmly discuss something(Required) Never Less than once a month Once or twice a month Once a day More often Quarrel with each other(Required) Never Less than once a month Once or twice a month Once a day More often Discuss or threaten the possibility of divorce, separation, or terminating your relationship(Required) Never Less than once a year About once a year More than once a year but less than monthly About monthly Every one to two weeks More than weekly Please answer the following true/false about your intimate life with your partnerMy relationship is romantic and passionate.(Required) Very True More True than False Neutral More False than True Very False My partner and I touch each other a fair amount.(Required) Very True More True than False Neutral More False than True Very False Sex with my partner is sexually satisfying.(Required) Very True More True than False Neutral More False than True Very False The frequency of sex is not a problem.(Required) Very True More True than False Neutral More False than True Very False Being able to just talk about sex, or talk about sexual problems, is not a serious issue between us.(Required) Very True More True than False Neutral More False than True Very False My partner finds me sexually attractive.(Required) Very True More True than False Neutral More False than True Very False I find my partner sexually attractive.(Required) Very True More True than False Neutral More False than True Very False Considering only the POSITIVE qualities of your relationship and ignoring the NEGATIVE ones, please rate your relationship on the following.Enjoyable(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Strong(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Alive(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Fun(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Considering only the NEGATIVE qualities of your relationship and ignoring the POSITIVE ones, please rate your relationship on the following.Miserable(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Dull(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Weak(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true Discouraging(Required) Not at all true A little true Somewhat true Mostly true Very true Completely true This last section describes a few hypothetical scenarios. Imagine your partner performing each behavior and then read the statements and choose how much you agree or disagree with the statement.Scenario 1. Your partner criticizes something you say.My partner did this on purpose and not unintentionally (Scenario 1)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly The reason my partner did this is part of a larger problem that affects other areas of our marriage (Scenario 1)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly This is something that likely will not change (Scenario 1)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly Scenario 2. Your partner begins to spend less time with you.My partner did this on purpose and not unintentionally (Scenario 2)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly The reason my partner did this is part of a larger problem that affects other areas of our marriage (Scenario 2)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly This is something that likely will not change (Scenario 2)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly Scenario 3. Your partner is cool and distant with you.My partner did this on purpose and not unintentionally (Scenario 3)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly The reason my partner did this is part of a larger problem that affects other areas of our marriage (Scenario 3)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly This is something that likely will not change (Scenario 3)(Required) Disagree strongly Disagree Disagree somewhat Agree somewhat Agree Agree stronly Review and uncheck if not applicable I am a current or possible future client of Karuna Healing Recovery Coaching and Therapy Services and consent to allow my therapist or coach to view my report in order to analyze and discuss the results with me.
