Personal Information * Name * Email * Phone next Questions * 1. What does quality time means to you? A. Going to movies B. One on One Lavish Outing C. Day trip to the beach with a picnic lunch * 2. Do you feel your partner listen's and understands you? Yes No * 3. Do you and your partner argue? Yes No * 3a. If YES, how do you feel afterwards? Angry Hurt Frustrated Shutdown All of the above * 4. Are there things about your partner you would like to change? Yes No * 5. Do you feel there are areas in your relationship you could and would like to improve? Yes No back reset submit All done!Thanks for giving your time to answer our 30 second quiz to find out how healthy your relationship is! We will be in touch with you soon to talk more about your results. Go back to Home Page Please turn on javascript to submit your data. Thank you!