Intentional Love Pre-Challenge Survey
Put the Sparks Back in Your Relationship!
Email address
Name
Your answer
Location (City, State, Country)
Your answer
Age
Your answer
How well does your partner meet your needs?
Low
High
In general, how satisfied are you with your relationship?
Low
High
How good is your relationship compared to most other relationships?
Low (less good)
High (better than)
How often do you wish you had NOT gotten into this relationship?
Low (less frequently)
High (more frequently)
To what extent has your relationship met your original expectations:
Low
High
How much do you love your partner?
Low
High
How many problems are there in your relationship?
Low
High
Relationship Status
Length of Relationship
Annual Household Income
Your Race/Ethnicity
Is your relationship....
Are you currently in couples counseling?
Have you ever been in couples counseling?
Why did you stop couples counseling?
Your answer
What are the strengths of your relationship currently?
Your answer
How would you like to see your relationship grow?
Your answer
What kind of Intentional Love Challenges do you think would benefit your relationship?
Your answer
What is your intention/hope/expectation for the Intentional Love Challenge?
Your answer
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