SELF-ASSESSMENT FOR MARRIED PEOPLE: AM I AS HAPPILY MARRIED AS I WANT TO BE?

Please answer the following questions on a scale of 1 to 5, with 1 being the least and 5 being the most.

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* 1. Please enter the following information:

Name

Age

Email Address

Phone Number

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* 2. How did you learn of this assessment?

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* 3. Is your home a place of peace and acceptance for you?

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* 4. Are you greeted pleasantly by your spouse when you get home?

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* 5. Does your spouse carry his/her fair share of the load in caring for your children or relatives in need?

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* 6. Does your spouse appreciate the work you do to care for children or relatives in need?

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* 7. Do you and your spouse discuss differences of opinion calmly, pleasantly, and constructively?

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* 8. Do you feel free to bring up any topic for discussion with your spouse, without fear that he/she will respond angrily or defensively?

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* 9. How thoroughly have you and your spouse discussed your long term goals in life?

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* 10. Are you and your spouse in agreement about appropriate ways to spend your money?

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* 11. Does your spouse cheerfully satisfy your sexual desires?

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* 12. Do you feel appreciated as a lover by your spouse?

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* 13. Are you pleased with your spouse's eating habits?

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* 14. Does you spouse praise your approach to health and fitness?

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* 15. Are there activities that you and your spouse both enjoy together?

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* 16. Does your spouse cheerfully let you spend time in activities that you enjoy?

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* 17. Do you and your spouse share a set of spiritual values or religious beliefs?

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* 18. Does your spouse cheerfully support your religious or spiritual endeavors?

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* 19. Do you feel you know and understand your spouse more deeply and thoroughly than anyone else in the world does?

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* 20. How well do you know and "speak" your spouse's "love language?"

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* 21. After making a mistake in life, how readily do you and your spouse apologize and take other steps toward earning forgiveness?

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* 22. How consistently do you and your spouse give each other the benefit of the doubt, and judge each other favorably?

Thank you for taking this assessment. Dr. Paul will contact you to schedule a complementary appointment for visiting his office and reviewing your results together.