NAME:
SECTION:
HOW DO YOU FEEL ABOUT YOUR RELATIONSHIP
Criteria/ Relationship FAMILY FRIENDS PARTNER ORGANIZATIONS
I. Overall feelings about the relationship:
Are you getting your needs met? ✓ ✓ ✓ NONE
Are you speaking up and asking for what you want? ✓ ✓ ✓ NONE
Are you feeling heard? ✓ ✓ ✖ NONE
Are you feeling encourage and supported to grow? ✓ ✓ ✓ NONE
II. The decision-making process:
Are decision made to your satisfaction? ✓ ✓ ✖ NONE
Is there sufficient time to discuss, assess, and process? ✓ ✓ ✓ NONE
Do you feel as though your thoughts and feelings are ✓ ✓ ✓ NONE
taken seriously?
Is there a collaborative spirit about decisions? ✓ ✓ ✓ NONE
III. Communication
Do you feel safe to say whatever you feel? ✓ ✓ ✓ NONE
Do you feel listened to when you communicate? ✓ ✓ ✖ NONE
Do you feel encouraged to tell your truth? ✓ ✓ ✖ NONE
Do you feel supported in all your dreams and goals? ✓ ✓ ✓ NONE
IV. Roles and responsibilities
Do you feel the division of tasks is working? ✓ ✓ ✓ NONE
Do you feel that both of you are doing your parts? ✓ ✓ ✖ NONE
Do you feel that task allocation is fair? ✓ ✓ ✖ NONE
Is there anything that you want to change? ✖ ✖ ✖ NONE
V. Activities
Do you feel like you spend enough time together? ✓ ✓ ✓ NONE
Do you feel like you need more time alone? ✓ ✓ ✓ NONE
Do you want to try something new? ✓ ✓ ✓ NONE
VI. Planning, schedules, and logistics:
Are you experiencing any schedule conflicts you want to ✓ ✓ ✓ NONE
address?
Are there financial agreements that are fair? ✓ ✓ ✓ NONE
Does each of you have enough time to accomplish ✓ ✓ ✓ NONE
everything you want?
-Therelationship with my family and friends is have more check while
my partner have many X so I need to be more responsible in my
romantic relationship meanwhile my relationship in organization is
none so I need to be more socialize.