1. When it comes to sharing text messages, passwords and other personal information, how likely are you to do this?
A. Very likely
B. Somewhat likely
C. Not very likely
D. Not likely
2. Do you tend to push others away in a relationship?
A. No, not at all
B. Rarely
C. Sometimes
D. Frequently
3. Did you have experiences in your childhood where you were hurt physically or emotionally by your parents or another adult?
A. Yes
B. Sometimes
C. Not often
D. Never
4. Are you overly cautious of your partner being unfaithful because you doubt whether their intentions are genuine?
A. Yes
B. Sometimes
C. Not often
D. Never
5. Would you say you have trust issues?
A. Definitely
B. Many times
C. It depends on the situation, but sometimes I do
D. No, not at all
6. Do you feel like you are very critical of others?
A. Rarely
B. Sometimes
C. Frequently
D. Yes, definitely
7. How would you say you react to constructive criticism?
A. I always have a hard time with any type of criticism because it makes me really upset
B. Criticism doesn’t really bother me if it is constructive
C. I don’t let criticism ever get to me
D. Sometimes it still makes me upset, even if it is constructive
8. What ended your last relationship?
A. I wasn’t what they were looking for
B. Infidelity
C. My partner felt suffocated
D. My partner was not meeting my expectations
9. Would you say you are confident in yourself?
A. No, not at all
B. Not most of the time
C. Sometimes
D. Yes, most of the time
10. Would you consider yourself a doormat who lets others walk all over you and take advantage of your kindness?
A. Yes, I tend to do that
B. Sometimes, but not always
C. Most of the time I do not
D. No, I don’t let others treat me that way
