1. On a scale from 1-4 (1=least important, 4=most important), how important is gift-giving and doing little things for others just to show how much you care in a relationship?
2. On a scale from 1-4 (1=least important, 4=most important), how important are encouragement, compliments, and verbal affection in a relationship?
3. On a scale from 1-4 (1=least important, 4=most important), how important is actively listening, spending quality time together and giving your undivided attention to the other person in a relationship?
4. What did you feel like you needed more of in your last relationship?
A. Appreciation and communication
B. Affection and attention
C. Kind gestures and confirmation of their feelings for me by doing nice things
D. Physical intimacy and other physical signs of attraction/attention
5. What were the majority of your fights/arguments/disagreements about that ended previous relationships?
A. Not feeling like they really cared about me and not getting any validation or confirmation of their feelings for me anymore
B. Not having time for each other or not spending quality time together without any distractions
C. Not feeling special or like they never went out of their way just to do kind things anymore like they used to
D. lack of intimacy and affection
6. Which of these are you most likely to do to show someone you care about them?
A. Send them a text or leave them a cute note just to let them know I care
B. Give them my undivided attention, so they know they are most important to me
C. Buy them small gifts when something reminds me of them or make something special for them as an expression of my love
D. Hug them, kiss them, and show affection in other physical ways
7. Which of these would you enjoy most from your partner?
C. Going out of their way to do things for me/helping me with whatever I need
D. An intimate time in bed
8. What makes you feel happiest in a relationship?
A. Encouragement, compliments, and appreciation
B. Being present, focusing all attention on you, and not letting electronic devices preoccupy them when they are with me
C. Going out of their way to do nice things for me
D. Being physically close and knowing the other person is drawn to me
9. What’s your perfect date night?
A. Going to dinner and them surprising me with a poem/love note they wrote themselves to show appreciation and point out all the great things about me
B. In a quiet corner at a bar or at home deep in conversation, enjoying each other’s company like you are the only two people in the world
C. Surprising me with dinner they made for me, my favorite drink, and a movie they picked out that they think I would love
D. Going out of their way to do nice things for me
10. On a scale from 1-4 (1=least important, 4=most important), how important do you think showing physical affection is in a relationship?