Relationship satisfaction
On the scale below, choose the number that best describes the degree of satisfaction you feel in the various aspects of your relationship. The scale gradually ranges from the least possible satisfaction on the left to the greatest satisfaction on the right.
Sign in to Google to save your progress. Learn more
1st name and initial *
e.g. Chris S
0 = Very dissatisfied
1 = Moderately dissatisfied
2 = Slightly dissatisfied
3 = Neutral
4 = Slightly satisfied
5 = Moderately satisfied
6 = Very satisfied
1. Communication and openness
2. Resolving conflicts and arguments
3. Handling of finances
4. Sexual satisfaction
5. Recreational activities and leisure time
6. Sharing duties and household chores
7. Raising of children (skip this if you have no children).
Clear selection
0 = Very dissatisfied
1 = Moderately dissatisfied
2 = Slightly dissatisfied
3 = Neutral
4 = Slightly satisfied
5 = Moderately satisfied
6 = Very satisfied
8. Degree of affection and caring
9. Relating to friends and relatives
10. Intimacy and closeness
11. Satisfaction with your role in the relationship
12. Satisfaction with your partner’s role in the relationship
13. Overall satisfaction with your relationship
14. Overall satisfaction with your life and self
Clear selection
Optional comments can go here
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms