Family Interaction Relationship Survey Form
Please answer the following questions to help us understand the dynamics and interactions within your family.
How often do family members communicate openly with each other?
*
Always
Often
Sometimes
Rarely
Never
How would you rate the level of support family members provide to each other?
*
1
2
3
4
5
Family members show respect for each other's opinions.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
How are conflicts typically resolved in your family?
*
Through open discussion
Avoided or ignored
With compromise
With arguments
Other
Which activities do you most often share with your family? (Select all that apply)
*
Meals
Recreational outings
Watching TV/movies
Religious or cultural events
Household chores
Other
How comfortable do you feel expressing your feelings to family members?
*
Not at all comfortable
1
2
3
4
Very comfortable
5
1 is Not at all comfortable, 5 is Very comfortable
Who usually makes important decisions in your family?
*
One parent/guardian
Both parents/guardians together
Children are involved
Decisions are shared by everyone
Other
Family members encourage each other to pursue personal goals.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
How would you describe the overall emotional closeness in your family?
*
Very close
Somewhat close
Neutral
Somewhat distant
Very distant
In a few words, what is one thing you value most about your family relationships?
*
Submit
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