Relationship Structures Questionnaire Form

Relationship Structures Questionnaire Form
Complete this questionnaire to describe your relationship structure, living arrangement, communication patterns, support system, challenges, and goals.
Respondent Overview
Current relationship status
Relationship structure description
How long have you been in this relationship structure?
Relationship Composition
Types of relationship(s) involved
Other
Number of people involved in the relationship structure
Arrangement structure
Other
Living and Daily Arrangement
Household / living arrangement
Other
Who lives in the household?
How are daily responsibilities shared?
Rows Mostly me Shared equally Mostly others Not applicable
Meals
Cleaning
Shopping
Bills/Finances
Childcare/Dependents
Transportation
Communication and Decision-Making
How would you rate the quality of communication in this relationship?

1
2
3
4
5
6
7
8
9
10
1 is Poor, 10 is Excellent
Who usually makes important decisions in this relationship?
Other
Briefly describe how important issues are discussed and resolved.
Support, Challenges, and Goals
Current support network
Other
Biggest relationship challenges
Other
Relationship goals and what you hope to improve or understand
Should be Empty:

Select theme: