JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
THE KINGS TABLE Marriage Health Survey
Understanding the health of your marriage is key to a knowing what KING MOVES that you must make.
* Indicates required question
Email
*
Record my email address with my response
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone Number
*
Yes, send me my survey results! I agree to receive email & text msg marketing material from The Stay Married Movement that we think you will love. Opt-out anytime. Msg & data rates may apply.
Your answer
Which or how many of these 4 things show up in your interactions with your wife?
*
10 points
Criticism - Complaining about what is wrong in your relationship
Contempt - Holding wrongs done against one another without forgiveness
Combat - Fighting to be right and not showing empathy
Conceal - Going inward instead of engaging in conversation just to keep the peace
None - We dont have any of these in our relationship
Required
What is your #1 issue or goal you would like to improve or accomplish in your marriage in the next 90 days?
*
5 points
Your answer
Do you and your spouse have a written vision or plan to achieve this goal?
*
5 points
Yes
No
Do you have a regular time daily that you study the bible and pray?
*
5 points
Yes
No
Do you have a set time that you and your wife/fiancè pray and study the word together?
*
10 points
Yes
No
Are you a part of a marriage or mens life group?
*
5 points
Yes
No
Do you have a regular weekly or monthly date night?
*
5 points
Yes
No
Have you and your spouse attended marriage conference within the last 2 years?
*
5 points
Yes
No
Rate your current level of health and satisfaction in your relationship.
*
5 points
1
2
3
4
5
6
7
8
9
10
We equip men to restore peace, regain respect, and revive relationships. Would you like us to message you explaining how?
*
0 points
Yes
No
Thanks for taking this short Marriage Health Survey. Download your Ebook at the link
HERE
A copy of your responses will be emailed to .
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report