Mini-Questionnaire

Mini-Questionnaire

1. On a scale of 1-7, how would you rate the feelings that you experienced as a result of reading the letter from your spouse?

Very Positive                                               Neutral                                                 Very Negative

      1                 2                  3               4              5                 6                 7

2. Considering your most recent conflict, on a scale of 1-7, how severe would you consider this conflict?

Not severe at all                               Moderately severe                                       Highly Severe

           1               2               3             4                    5                 6                          7

3. On a scale of 1-7, how kind would you rate your partner?

Very Unkind                                    Neutral                                              Very Kind

1             2                     3             4               5            6                   7

4. Which of the following topics would you consider your most recent conflict to be about?

a.   Finances

b.   Communication

c.   Division of Labor

d.   Time Management

e.   Intimacy

f.   Children

g.   In-laws

h.   Other __________

4. Approximately how long did the conflict last?

        Hours______ Minutes______