Couple Questionnaire
Name
First Name
Last Name
E-mail
1. What are the strengths of your relationship/marriage?
2. What are the challenges of your relationship/marriage?
3. How do you contribute to the strengths of your relationship/marriage?
4. How do you contribute to the challenges of your relationship/marriage?
5. What changes would you like to see in your relationship/marriage?
6. What are you willing to do to help these changes to happen?
Comments or Concerns:
Date
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Month
-
Day
Year
Date
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Submit
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