Marriage Anxiety Survey Form
Please share your experiences, concerns, and support needs regarding marriage anxiety. Your responses are confidential and used for general survey purposes only.
How often do you experience anxiety related to marriage?
*
Never
Rarely
Sometimes
Often
Always
Please rate the intensity of your marriage-related anxiety.
*
1
2
3
4
5
Which of the following are your main concerns about marriage? (Select all that apply)
*
Fear of conflict
Loss of independence
Financial stress
Family expectations
Fear of divorce
Other
How much do the following situations trigger your marriage-related anxiety?
*
Rows
Not at all
A little
Somewhat
Very much
Disagreements with partner
1
2
3
4
Discussing future plans
5
6
7
8
Interactions with in-laws
9
10
11
12
Financial discussions
13
14
15
16
Wedding planning
17
18
19
20
Have you ever sought support for marriage-related anxiety?
*
Yes
No
If yes, what type of support have you used? (Select all that apply)
Friends/family
Counseling/therapy
Online resources
Support groups
Other
How helpful have you found the support you received?
Not at all helpful
1
2
3
4
Extremely helpful
5
1 is Not at all helpful, 5 is Extremely helpful
What type of support would you prefer to help manage marriage anxiety?
*
Please Select
Individual counseling
Couples counseling
Workshops/seminars
Online resources
Peer support groups
Other
To what extent do you feel comfortable discussing marriage anxiety with your partner?
*
Not at all comfortable
1
2
3
4
Very comfortable
5
1 is Not at all comfortable, 5 is Very comfortable
Please share any additional comments or experiences related to marriage anxiety.
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