Family Roles Questionnaire Form

Family Roles Questionnaire Form
Please complete this questionnaire to help us understand your family structure, roles, and how responsibilities are shared in your household.
What best describes your family structure or household type?
What is your primary role in the family?
List other family members in your household and their relationship to you.
Who is primarily responsible for daily household tasks?
Who usually makes important family decisions?
How are responsibilities shared in your family?
Rows Mostly me Shared equally Mostly another family member Not applicable
Household chores
Childcare
Financial management
Emotional support
Planning family activities
How often are conflicts discussed and resolved in your family?
What types of support do you provide to other family members?
Other
What types of support do you receive from other family members?
Other
Additional comments or details about family roles (optional)
Should be Empty:

Select theme:

Rows	Mostly me	Shared equally	Mostly another family member	Not applicable
Household chores
Childcare
Financial management
Emotional support
Planning family activities