1. Which of these describes your feelings best?
A. Tender passion and affection
B. Adoration or serious attraction
C. A quick rush of passion
D. Falling head over heels
2. What do your feelings feel most like to you?
A. Addiction, insecurity or fear of losing him
B. Adoration and infatuation
C. Uncontrollable Desire
D. Calm, committed and dedicated
3. How do your feelings affect your daily life negatively?
A. Making more irrational decisions that you end up regretting later
B. Sometimes making a fool of yourself
C. Extreme urges to have this person in your life
D. I haven’t experienced any negative effects
4. Do you feel like the attraction is more physical or emotional?
A. Heavy physical attraction, mostly physical
B. Attraction or common interests, more than emotional
C. Intense/Unhinged Obsession that’s physical and not emotional
D. Both physical and emotional equally
5. How long have you been experiencing these feelings?
A. A few weeks
B. About a month
C. Less than a few weeks
D. More than a month
6. What is the status of your relationship with this person?
A. I believe it is one sided and they don’t feel the same towards me
B. I believe it is one sided and they don’t feel the same towards me
C. I am not sure they know I exist and/or feel this way
D. It is a mutual platonic relationship
7. How do you know this person?
A. An acquaintance who lives in the same neighborhood/area
B. Through mutual friends
D. A dating site
8. How would you describe your feelings when you see this person?
A. Intense and dramatic
B. Can’t get them out of my mind all day
C. Uncontrollable Passion and desire
D. Butterflies and confidence in the mutual feelings
9. Do you believe your feelings towards this person are healthy and controllable?
A. Most of the time they are out of my control
C. They are not healthy or controllable
D. They are healthy and under my control
10. Have you ever had an actual relationship with this person?
A. No, just brief interactions
B. Yes, but not exclusively
C. No, not at all
D. Yes, exclusively