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1. Years of Marriage
(required)
2. Spouse
(required)
3. Ethnic Structure
(required)
4. Indicate your satisfaction
with the amount of
romance
in your marriage
(Romance involves the tender things spouses do to and with each other (no sex) to show how much they love each other) (required)
5. Indicate your satisfaction
with the amount of
time
spent together doing fun things, dating, relaxing.
(required)
6. Indicate your satisfaction
with the
intimacy
in your marriage.
(Intimacy is the sharing of parts of your life that you should only share with your spouse, whether it is intellectual, spiritual, emotional or sexual. Intimacy involves sharing your joys and your pains, your wants and your likes, your agreements and disagreements) (required)
7. Indicate your satisfaction
with the
friendship
in your marriage.
(A friend is someone with home you enjoy doing simple and everyday things with. You enjoy being in each other's presence and feel comfortable sharing ideas and thoughts together) (required)
8. Have you ever been
emotionally abused
by your husband?
(required)
9. Have you ever been
emotionally abused
by your wife?
(required)
10. Have you ever been
physically abused
by your husband?
(required)
11. Have you ever been
physically abused
by your wife?
(required)
12. Do your feel frustrated at times because your spouse interprets touching and cuddling to mean it's time to have sexual intercourse?
(required)
13. Did you and your spouse make love within the past seven days?
(required)
14. Do you enjoy being sensual and romantic without making love?
(required)
15. Ask a question or make a comment in the box below. Do not identity yourself.
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