1. How would you feel if your former partner entered a new relationship?
A. I would feel hurt
B. I would feel fine about it
C. I would feel a combination of emotions
2. Has your partner ever cheated during your relationship?
A. Yes, I know my partner has cheated on me
B. No, my partner was never unfaithful
C. I am unsure
3. What did your friends and family think of your relationship?
A. They did not approve of the relationship
B. They hoped we would get married
C. They were indifferent
4. Have you ever done anything to hurt your former partner’s feelings?
A. No, I would never intentionally hurt the person I love
B. I don’t know if I know
C. Yes, I have hurt my partner’s feelings
5. How would you rate the overall quality of your relationship?
A. It was great, healthy, and respectful
B. It needed some improvement
C. It was a pretty bad relationship
6. If you would change one thing about your relationship, what would it be?
A. I wouldn’t change anything at all
B. More communication, trust, and honesty would be needed
C. I would change everything
7. Are both you and your partner willing to work through past issues?
A. I am, but I’m not sure if my partner is
B. I don’t need to work on anything
C. We both accept responsibility and are ready to move forward
8. Do you consider yourself a forgiving person?
A. Yes, I am usually very forgiving
B. I am somewhat forgiving, depending on the circumstances
C. No, once my trust is broken, I can’t forgive
9. Do you see yourself dating anyone else?
A. I have thought about dating someone new
B. No, I can’t envision myself with another person
C. Yes, I have intently imagined dating others
10. Do you believe that your former partner could be “the one”?
A. Yes, I believe that to be true
B. No, I don’t think we’re a perfect match anymore
C. I don’t know
