Transcription of COUPLES RELATIONSHIP ASSESSMENT FORM
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COUPLES RELATIONSHIP ASSESSMENT FORM
Valee More Page 1 of 6 09 832-9273 021 250-5039 COUPLES RELATIONSHIP ASSESSMENT form Name: _____ Date: _____ 1. The areas of our RELATIONSHIP that are working well for me are: 2. The areas of our RELATIONSHIP that are not working well for me are: 3. I want to improve the following RELATIONSHIP and/or communication skills: ___ Balancing work/family/social/etc. ___ Learning Caring behaviors that feed the heart ___ Understanding/knowing my partner ___ Facing challenges ___ Sharing Interests & Fun ___ Keeping chemistry alive ___ Deepening emotional and physical intimacy ___ Being a conscious communicator ___ Being a conscious listener ___ Improving Negotiation/Conflict Resolution ___ Releasing hurtful reactions ___ Softening my approach ___ Using Soothing techniques for myself/partner ___ Improving Calming strategies ___ Creating rituals of connection ___ Expressing differences effectively ___ Requesting vs.
COUPLES RELATIONSHIP ASSESSMENT FORM Name: _____ Date: _____ 1. The areas of our relationship that are working well for me are: 2. The areas of our relationship that are not working well for me are: 3. I want to improve the following …
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