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COUPLES RELATIONSHIP EVALUATION

The Relationship Evaluation for Couples is designed to give you and your partner feedback about the health of your relationship. No one can see your results but you. In addition to receiving a score, you will get practical suggestions to improve the quality of your relationship. You can take the evaluation individually (with the feedback reflecting your perspective) or as a couple (with the feedback reflecting a joint perspective).

Instructions: Please rate the statements below using the following “Rating Scale.” Your average score will be calculated automatically and your “Evaluation Results” will appear. Then read the summary associated with your score from Lori & Bob Hollander about the steps you and your partner can take to improve your relationship.

Rating Scale: 4 – Always 3 – Frequently 2 – Sometimes 1 – Seldom 0 – Never



1. My partner and I accept each other unconditionally.
0
1
2
3
4

2. I feel our relationship is my partner’s highest priority.
0
1
2
3
4

3. Mutual trust and honesty exists in our relationship.
0
1
2
3
4

4. I feel respected and admired by my partner.
0
1
2
3
4

5. The balance between “time together” and “time apart” works for me.
0
1
2
3
4

6. My partner and I enjoy each others company and like doing things together.
0
1
2
3
4

7. My partner lets me know in words and actions that he/she loves me.
0
1
2
3
4

8. My partner and I share our problems with each other.
0
1
2
3
4

9. My partner listens with empathy.
0
1
2
3
4

10. We try to understand each other when difficulties arise and are able to resolve conflicts.
0
1
2
3
4

11. We are able to tell each other what we need without blaming.
0
1
2
3
4

12. We both apologize when we are wrong.
0
1
2
3
4

13. We are both able to forgive when the other apologizes.
0
1
2
3
4

14. I am satisfied with the amount of affection in our relationship.
0
1
2
3
4

15. Our sexual relationship is mutually satisfying.
0
1
2
3
4

 

 

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