1. Has your spouse ever been violent towards you?
A. Yes
B. No
C. They sometimes are
D. Only verbally
2. Do you still feel love for each other?
A. Yes
B. Sometimes
C. Not really
D. No
3. Do you still feel the magic you felt the first time you met each other?
A. Yes
B. You used to but not anymore
C. No
D. Sometimes
4. Do you feel you complete each other in your marriage?
A. Yes
B. No
C. sometimes
D. You used to but not anymore
5. Do you envy other couples all the time?
A. Yes, all the time
B. Sometimes
C. No really
D. No, you don’t need to
6. Do you regret being with your partner?
A. Yes, sometime
B. No
C. Yes, all the time
D. You don’t know, you’ll have to think about it
7. Does your partner degrade you in public?
A. Yes, all the time
B. No, never
C. Yes, sometimes
D. Yes, but it’s rare
8. Do you find your partner disrespectful?
A. Yes, all the time
B. No, never
C. Yes, sometimes
D. Yes, but it’s rare and it’s normally out of anger
9. Does your partner refuse to own responsibility for anything?
A. Yes
B. No
C. Sometimes
D. They used to be this way but not anymore
10. Do you feel happy in your relationship?
A. Yes, pretty much
B. No
C. To be honest you have your good and bad days in this relationship
D. You don’t know yet, you need to think about it
