Relationship Seminar Retreat questionnaire

Couples Questionnaire

"*" indicates required fields

Please take a few moments to complete this questionnaire as a couple. Your honest responses will help us understand your relationship better and tailor our services to meet your specific needs. All information provided will be kept confidential.

Name Partner #1*

First Last

Name Partner #2*

First Last

Are you Married? If yes, how long If no, relationship status*

Yes

How long have you been together as a couple?*

How Long have you been married?

Your Relationship Status?

Partner #1: - What are your primary reasons for attending the Relationship Seminar Retreat? (Select all that apply)

Strengthening our relationship

Communication improvement

Conflict resolution

Premarital assessment

Seeking guidance for specific issues

Other

Partner #2: - What are your primary reasons for attending the Relationship Seminar Retreat? (Select all that apply)

Strengthening our relationship

Communication improvement

Conflict resolution

Premarital assessment

Seeking guidance for specific issues

Other

Partner 1: Please Specify

Partner 2: Please Specify

Partner #1: On a scale of 1 to 10, how satisfied are you with your relationship overall? (1 being extremely dissatisfied, 10 being extremely satisfied)

Partner #2: On a scale of 1 to 10, how satisfied are you with your relationship overall? (1 being extremely dissatisfied, 10 being extremely satisfied)

Partner #1: What are the top three strengths you appreciate in your partner?

Partner #2: What are the top three strengths you appreciate in your partner?

Partner #1: What are the areas of improvement or challenges you would like to address in your relationship?

Partner #2: What are the areas of improvement or challenges you would like to address in your relationship?

Partner #1: How do you typically resolve conflicts as a couple?

Partner #2: How do you typically resolve conflicts as a couple?

Partner #1: What are your individual communication styles? (e.g., , passive, direct, indirect)

Assertive

Passive

Direct

Indirect

Partner #2: What are your individual communication styles? (e.g., , passive, direct, indirect)

Assertive

Passive

Direct

Indirect

Partner #1: Do you have any specific goals or expectations for your relationship in the next year? If yes, please describe.

Partner #2: Do you have any specific goals or expectations for your relationship in the next year? If yes, please describe.

Partner #1: How do you prioritize quality time and shared activities in your relationship?

Partner #2: How do you prioritize quality time and shared activities in your relationship?

Partner #1: Have you attended any previous couples therapy, coaching or relationship workshops? If yes, please provide details.

Yes

Partner #2: Have you attended any previous couples therapy, coaching or relationship workshops? If yes, please provide details.

Yes

Partner 1: Please Describe?

Partner 2: Please Describe?

Partner #1: Are there any significant life events or changes that have impacted your relationship recently? If yes, please describe.

Yes

Partner #2: Are there any significant life events or changes that have impacted your relationship recently? If yes, please describe.

Yes

Partner 1: Please Describe?

Partner 2: Please Describe?

Partner #1: How do you handle decision-making as a couple?

Partner #2: How do you handle decision-making as a couple?

Partner #1: What are your expectations regarding finances and financial responsibilities within your relationship?

Partner #2: What are your expectations regarding finances and financial responsibilities within your relationship?

Partner #1: How do you show affection and appreciation to your partner?

Partner #2: How do you show affection and appreciation to your partner?

Partner #1: Is there any other information you would like to share that you believe would be helpful for us to know?

Partner #2: Is there any other information you would like to share that you believe would be helpful for us to know?

Thank you for taking the time to complete this questionnaire. Your responses will assist us in conducting the relationship retreat.

Name

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