The Relationshop

Name *

First Name

Last Name

My trust has gone out the window. *

Yes

No

Sex has gone downhill. *

Yes

No

In all our daily interactions, about a third or more are negative. *

Yes

No

Sometimes I think my partner is trying to hurt me. *

Yes

No

Sometimes it seems we lose track of what we’re arguing about and the fight becomes about the fight. *

Yes

No

Over time, I find myself feeling more resentful towards my partner. *

Yes

No

S/he spends way too much time online. *

Yes

No

We don’t have fun like we used to. *

Yes

No

I find myself suspicious and checking his/her texts and emails. *

Yes

No

Sometimes I think if it weren’t for the kid(s) I’d be outta here. *

Yes

No

Our discussions tend to escalate into arguments and spiral out of control *

Yes

No

I see my partner as essentially selfish (or: negative/argumentative/arrogant) *

Yes

No