Relationship Intimacy Checklist Form
Reflect on key aspects of your relationship with this approachable, minimal checklist. The "Relationship Intimacy Checklist Form" helps you consider important areas of connection and growth.
How often do you and your partner have meaningful conversations?
*
Daily
Several times a week
Once a week
Rarely
How comfortable do you feel sharing your feelings with your partner?
*
1
2
3
4
5
How much do you trust your partner?
*
1
2
3
4
5
How often do you and your partner spend quality time together?
*
Daily
Several times a week
Once a week
Rarely
How supported do you feel by your partner in your personal goals?
*
1
2
3
4
5
How do you and your partner typically resolve disagreements?
*
Please Select
Calm discussion
Take a break and revisit
Avoid the topic
Other
How much do you and your partner share similar values and life goals?
*
1
2
3
4
5
How comfortable are you with the level of affection in your relationship?
*
Very comfortable
Somewhat comfortable
Neutral
Uncomfortable
How often do you and your partner try new activities together?
*
Frequently
Occasionally
Rarely
Never
Is there anything else you’d like to reflect on regarding your relationship?
Submit
Should be Empty: