The primary objective of a love relationship questionnaire is to understand if there is any love in the relationship at all or is the relationship more on a materialistic plane or to satisfy physical needs. This is an important questionnaire that helps partners or couples decide whether the love is alive or dying in their relationship and also helps them to make the love relationship better accordingly.

Sample Love Relationship Questionnaire:

Name of the respondent: _____________________

Sex: _________ Age: _____________   Relationship Status: _______________

Address: _____________________________ State: ________  Zip: _________

Phone Number: ______________

Email Address: ______________

Q1.  How much do you want to stay in your current relationship?

  • Completely
  • Very much
  • I am fine
  • Sometimes I want to get out
  • Don’t want to stay at all

Q2. You and your partner have grown in this love relationship?

  • Strongly agree
  • Agree
  • Am not sure
  • Disagree
  • Strongly Disagree

Q3. How is your sex life?

  • Amazing
  • Very good
  • Good
  • Average
  • Doesn’t exist at all

Q4. How often do you spend good quality time with your partner?

  • Everyday / Every night
  • Once in week
  • A few times in a week
  • Once in a month
  • A few times in a month
  • Once in few months

Q5. Choose the factors from the list below that contribute towards your love relationship?

  • Intimacy
  • Time spent apart
  • Time spent together
  • Communication and understanding
  • Generosity and compassion
  • Family
  • Financial security
  • Trust
  • Physical attractiveness
  • Others

Q6. How many times does your partner say “I Love You”?

  • Everyday
  • Quite often
  • Often
  • Sometimes
  • Rarely

Q7. How do you prioritize the following? Write 1-6 in front of each of them.

  • Your career or job: ___
  • Your partner: ___
  • Your family: ___
  • Yourself: ___
  • Your hobbies: ___
  • Your friends : ___