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Relationship concerns
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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Secured
Survio
1
How often do you check in on your partner's mood, ie. are you okay? have I annoyed you?
Select one answer
Never
1-2 times a week
Once or twice a day
2-5 times per day
10 + times per day
Continue
2
How often do you check with your partner how they are feeling about the relationship, ie are we okay?
Select one answer
Never
Yearly
Monthly
Weekly
Daily
Several times per day
Continue
3
How often do you have thoughts or worries that your partner will end the relationship/leave?
Select one answer
Never
Rarely
Occasionally
Frequently
Daily
Submit