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Please note:
No personal identifying information is collected with this form.
The details submitted are one’s own perceptions, feelings and thoughts about your experience(s).
You are welcome to leave a question unanswered, but mention “I would not like to answer it as of now”.
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As of now, what is your expectation out your marriage/relationship?
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Why do you want to work on this marriage/relationship?
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What do you think as gone well in your marriage/relationship?
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What do you expect to be happening for you to call it as a successful marriage/relationship? (Being specific would help)
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Narrate THREE instances in your past in relation to this marriage/relationship where you personally feel your spouse/partner let you down. (This exercise is to understand you better rather than to see who is right or wrong)
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How do YOU want to keep your interactions with your family of origin (parents/siblings) and your family of procreation (in laws)
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How do you want YOUR PARTNER to keep his/her interactions with his/her family of origin (parents/siblings) and his/her family of procreation (in laws)
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Mention 3 changes which you DEFINITELY want your spouse/partner to consider.
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Mention 3 things you want to work on yourself for the betterment of your marriage/relationship.
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