1. Are there still things from your previous relationship(s) that bother you at times or cause you to feel unsure of yourself and your future relationships?
A. Of course, but I am ready to leave them behind
B. Sometimes, but I have come a long way
C. No, I never think about any of that anymore
2. Do you know exactly what you want in life and in a relationship and feel confident in your ability to communicate that to another person?
A. I am not sure
B. I think I have a general idea
C. Yes 100%
3. Are you self-sufficient and financially stable?
A. I struggle, but I get by
B. Sometimes, but not 100%
C. Yes, I have worked hard to get where I am
4. How would you describe yourself during times of stress?
A. A loose cannon
B. Sometimes anxious, but other times I can manage
C. Focused and in control
5. What would your ex say is your biggest flaw? (You don’t have to agree)
B. Inconsistent/Not always prioritizing your relationship over other things
6. Have you thought about what you would do differently in your next relationship that will make it successful?
A. I wasn’t the problem in my relationship, it was my ex
B. There are some things I could change, but not much
C. Yes, I have realized there are things I definitely could have done differently and plan to change those things in my next relationship
7. Do you feel like you are ready for a boyfriend?
A. I’m not sure
B. I think so
C. Yes, I do
8. Are you willing to open up entirely to another person and let them get to know your true self?
A. I don’t know think I could open up entirely yet
B. I would take it slow, but over time I would hope to get that comfortable
C. Yes, I am willing to do that
9. How long has it been since you’ve been in a serious relationship?
A. Within the last 6 months
B. Within the past year/I never had a serious relationship
C. Over a year
10. Are you completely happy with your life right now and all you have accomplished?
A. Not really
B. I wouldn’t say completely, but I am getting there
C. Yes I am