Lynne E. Sheridan
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Do you feel supported by your partner in your choices?
Yes
No
Does your partner encourage you to try new things or challenge yourself?
Yes
No
Does your partner listen to you and ask questions about what matters to you?
Yes
No
Do your friends like your partner?
Yes
No
Does your partner get jealous of the time you spend with friends, family or other activities?
Yes
No
Does your partner get upset if you do not respond to texts or calls or expect more consistent texting or calls from you?
Yes
No
Does your partner try to limit your time with friends or family?
Yes
No
Does your partner attempt to control your clothing choices?
Yes
No
Does your partner call you names when angry, berate or belittle you?
Yes
No
Does your partner consistently blame you for things rather than be responsible?
Yes
No
Does your partner have big mood swings, taking out anger on you?
Yes
No
Does your partner threaten you in any way?
Yes
No
Does your partner encourage you to bring up concerns that you have?
Yes
No
Is your partner possessive of you?
Yes
No
Do you laugh with your partner?
Yes
No
Do you enjoy being with your partner, even doing basic mundane activities?
Yes
No
Has your partner been unfaithful – physically, emotionally, energetically?
Yes
No
Does your partner know your favorite morning drink, dessert, food and pay attention to what you like?
Yes
No
Does your partner know more challenging things that have occurred in your life?
Yes
No
Do you feel free to express what you are comfortable with sexually and that your preferences will be honored?
Yes
No
Does your partner speak openly with you about what you currently enjoy about sexual activates and what you have enjoyed or not enjoyed in the past?
Yes
No
Do you feel listened to and cared for during sex?
Yes
No
Do you feel like sex occurs without much foreplay or concern for your gratification?
Yes
No
Do you feel your partner has an agenda about sex and that your desire and enjoyment are not as important?
Yes
No
Do you feel you and your partner share similar core values, like honesty, trust and respect?
Yes
No
Do you both do kind things for each other and offer emotional support when there are challenges?
Yes
No
Do you feel your accomplishments are celebrated and that you are encouraged to continue to grow and accomplish what matters to you?
Yes
No
Do you feel like you know each other well – past relationships, childhood wounds, struggles and goals for your lives?
Yes
No
Do you like your partner as a human being?
Yes
No
Does your partner take your opinions and input into account in decision-making?
Yes
No
Does your partner respect areas where you have different opinions?
Yes
No
Does your partner show you kindness and compassion?
Yes
No
Are you and your partner emotionally vulnerable with each other?
Yes
No
Does your partner forgive you?
Yes
No
Does your partner withhold their thoughts and feelings?
Yes
No
Does your partner take you for granted?
Yes
No
Does your partner neglect what you need?
Yes
No
Are there things you feel you cannot bring up with your partner?
Yes
No
Do you feel your partner fully hears you and listens to you?
Yes
No
Do you feel like you are equal partners that make decisions together and that no person is more in charge?
Yes
No
Do you feel that both partners feelings and thoughts are valued and cared for and important to the other?
Yes
No
Do you feel you effectively communicate around topics that may bring conflict?
Yes
No
Do you feel your partner supports your hopes, dreams and goals?
Yes
No
Are you both honest, open and transparent about your thoughts, feelings and actions?
Yes
No
Do you and your partner show each other appreciation and gratitude?
Yes
No
Do you touch each other, hold hands and cuddle not only during times of sexual intimacy and connection, but with regularity?
Yes
No
Do you feel that your relationship is a safe space where you are nourished and valued?
Yes
No
Do you make time to play together and have fun?
Yes
No
Do you make compromises when there are differences in opinion or desires?
Yes
No
Do you feel you can be yourself fully, making your own choices and living your life as you choose, and your partner can do the same with full support?
Yes
No
Where should we send your results?
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