Brain in Love Questionnaire

When your brain is the one in love then it has to do more with your mind being in love.  It means that your love is rational and well thought out.  You brain falling in love means that your consciousness has connected with another person in the rational part of your body which is the brain.  There are questionnaires available which can help you determine whether yours is a rational love or not.  In a survey trying to find out people’s feelings a questionnaire can come in handy.  It can help you decide whether your love should lead into marriage.

Your name: ____________________________________

Occupation: ____________________________________

Age group: _____________________________________

Location: _______________________________________

Economic status: _________________________________

Your partner’s name: ______________________________

Occupation: ______________________________________

Age group: _______________________________________

Location: _________________________________________

Economic status: ___________________________________

Please rate the following aspects about your relationship with very compatible, compatible, moderate, not very compatible, incompatible.

Hobbies: __________________________________________

Interests: __________________________________________

Dreams: ___________________________________________

Goals: ____________________________________________

Aspirations: ________________________________________

Family issues: ______________________________________

Money issues: ______________________________________

Plans for the future: __________________________________

Religion: ___________________________________________

Where to live: _______________________________________

Please rate the following aspects about your relationship with excellent, good, average, poor, very poor.

Commitment: _____________________________________

Intimacy: _________________________________________

Communication: ___________________________________

Romance: ________________________________________

Passion: __________________________________________

Attraction: ________________________________________

Please describe the hobbies you have in common with your partner:

________________________________________________________________________________________________________________________________________________

Please describe the interests that you have in common with your partner:

________________________________________________________________________________________________________________________________________________

Please describe the issues that bring problems into your relationship:

________________________________________________________________________________________________________________________________________________

Please describe some of the ways you resolve conflict in your relationship:

________________________________________________________________________________________________________________________________________________

Additional comments:

________________________________________________________________________________________________________________________________________________