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1. How long have you been married? (Required.)

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2. How fulfilled are you in your marriage?  (Required.)

Extremely Unfulfilled Extremely Fulfilled
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3. As with all marriages, hardships happen. What are the biggest issues you have to deal with in your marriage? (Required.)

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4. What is one thing your spouse can do that would make your relationship stronger? Have you told them about this?  (Required.)

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5. How often do you say one thing but really mean another thing?

Example #1: You would rather your spouse stay in with you than go out with friends but you say "It's fine - go out with them." 

Example #2: You really want Thai food but your spouse wants pizza. You agree to pizza, without saying anything. (Required.)

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6. When you aren’t completely honest in sharing your true feelings, thoughts, desires and expectations, why is that? (Required.)

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7. How likely are you to stay with your spouse if they stopped communicating effectively with you? (Required.)

Very likely Very Unlikely
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8. What is the hardest thing to talk about or communicate with your spouse? Do you still talk about it? (Required.)

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9. What I need most from my marriage right now is...

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10. What's the most important element for a marriage to last?

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11. How often do you feel this in your marriage?

Never Always
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