1. Does your partner take initiative in the relationship?
A. Yes, very often!
B. Rarely
C. Never
2. Are you always the one making plans in the relationship?
A. Yes
B. Sometimes
C. No
3. Does your partner give you gifts or compliments often?
A. Yes
B. Occasionally
C. No
4. Do you often feel like you're carrying the relationship all by yourself?
A. Yes, all the time!
B. Sometimes
C. No, never
5. Does your partner appreciate you or show affection?
A. Most of the time
B. Only sometimes
C. Never
6. Do you ever feel unwanted or ignored when you're with him?
A. Yes, all the time
B. Sometimes
C. No, never
7. Do you think he is unnecessarily irritable when he's with you?
A. Yes
B. A little bit
C. No
8. Does he verbally or physically abuse you?
A. Yes
B. Sometimes
C. No
9. Are you happy when you're with him?
A. Yes
B. Kind of
C. No
10. Do you have to force your partner to do the things you like?
A. Yes
B. A few times
C. No
