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Feedback on 1-Month Relationship with Boyfriend
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
How would you rate the communication in your relationship?
Please select one option.
Excellent
Good
Average
Poor
2
Rate your overall satisfaction with the relationship out of 10.
Please rate your satisfaction from 1 to 10.
3
What aspects of the relationship are you most happy with?
Please provide your answer in the text box.
4
Do you feel emotionally supported in the relationship?
Please select one option.
Yes
No
Sometimes
5
How often do you spend quality time together?
Please select one option that best describes your situation.
Every day
Few times a week
Once a week
Less often
6
Are you satisfied with the level of trust in the relationship?
Please select one option.
Completely
Mostly
Partially
Not at all
7
What are the main challenges you have faced in the relationship?
Please provide your answer in the text box.
8
Do you feel heard and understood in the relationship?
Please select one option.
Yes
No
Sometimes
9
How likely are you to recommend the relationship to a friend?
Please rate your likelihood from 1 to 10.
10
What do you envision for the future of the relationship?
Please provide your answer in the text box.
Submit