The love life questionnaire has been designed to help men and women decide if their love life is just fine or do they need to change certain aspects to make their love life better. Sometimes the love life questionnaire can also help a person in determining if their love life is dead or is spiraling downwards.

Sample Love Life Questionnaire:

Name of the respondent: _____________________

Sex: _________ Age: _____________   Relationship Status: _______________

Address: _____________________________ State: ________  Zip: _________

Phone Number: ______________

Email Address: ______________

Q1.  Which of the following does your partner share with you?

  • Personal information
  • Deep personal and emotional thoughts
  • Personal music or video CD collection
  • Personal space

Q2. Which of the following fits your partner’s profile?

  • A good listener
  • A good therapist
  • A strong shoulder to cry on
  • A good friend and guide

Q3. What type of attitude profile does your partner fit?

  • Casual
  • Serious
  • Emotional
  • Warm & Affectionate
  • Generous
  • Positive

Q4. Which of the following principles does your partner value the most in the relationship?

  • Honesty
  • Sincerity
  • Respect partner
  • Self-respect
  • Faithfulness

Q5. How often do small arguments with your partner escalate into fights?

  • Never
  • Once in a while
  • Quite frequently
  • Always

Q6. How often does your partner criticize you or belittles you?

  • Never
  • Once in a while
  • Quite frequently
  • Always

Q7. How often do you feel lonely in this relationship?

  • Sometimes
  • Quite a few times
  • Always
  • Never

Q8. How good is your partner’s communication with you?

  • Extremely good
  • Very good
  • Good
  • Fair
  • Average
  • Poor

Q9. How often do you go out for a dinner with your partner?

  • Once a week
  • Twice a week
  • Only on weekends
  • A few times in a month
  • Once a month
  • Once in many months