Spousal Intimacy and Romance Satisfaction

Spousal Satisfaction: Intimacy & Romance

The purpose of this questionnaire is to provide your partner/spouse with some feedback on your perspective on the level of intimacy and romance in the relationship. This questionnaire intends to identify areas for improvement. Please read each statement below and score 0 (needs improvement) – 10 (excellent). Then calculate each number at the end. Best results are experienced when you are authentic in your response. This questionnaire should not be employed to degrade or humiliate but establish a baseline so you can build a road map toward discovering your unique, intimate expressions.

Please read carefully and evaluate each sentence 0-10.

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* 1. What is your gender?

Female

Male

Non-Binary

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* 2. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Multiple ethnicity / Other (please specify)

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* 3. What is your age?

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* 4. Which of the following best describes your current relationship status?

Married

Widowed

Divorced

Separated

Cohabiting with a significant other or in a domestic partnership

Single, never married

Prefer not to answer

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* 5. When intimate with my spouse/partner, they attend to my sudden body changes, language, or signals.

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* 6. My spouse/partner's touch is gentle, compassionate, and loving. My mind, body, and soul melt in their hands.

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* 7. During foreplay, my spouse/partner takes his time with me instead of rushing to my genitals. My spouse/partner is not clumsy, rough, or poking.

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* 8. My spouse/partner assures I'm highly aroused before attempting penetration.

N/A

Spousal Intimacy and Romance Satisfaction

Spousal Satisfaction: Intimacy & Romance

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* 1. What is your gender?

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* 2. Which race/ethnicity best describes you? (Please choose only one.)

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* 3. What is your age?

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* 4. Which of the following best describes your current relationship status?

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* 5. When intimate with my spouse/partner, they attend to my sudden body changes, language, or signals.

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* 6. My spouse/partner's touch is gentle, compassionate, and loving. My mind, body, and soul melt in their hands.

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* 7. During foreplay, my spouse/partner takes his time with me instead of rushing to my genitals. My spouse/partner is not clumsy, rough, or poking.

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* 8. My spouse/partner assures I'm highly aroused before attempting penetration.

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* 9. My spouse/partner pays attention to my other needs, such as emotional, physical, mental, and spiritual.

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* 10. My spouse/partner is aware of my erogenous zones and frequents them when we're intimate.

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* 11. My spouse/partner uses words, ideas and fantasies that turn me on.

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* 12. Our lovemaking is inspiring, spontaneous with novelty, excitement and newness.

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* 13. My spouse/partner shows interest in my turn-ons and listens when I attempt to demonstrate methods to them.

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* 14. My overall satisfaction with our sex life.