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Relationship Survey Questions + Sample Questionnaire Template

Relationship survey questions by QuestionPro consists of questions and examples that you can carry out to understand the chemistry in a relationship, the factors that influence the health of a relationship, the challenges faced in a relationship and expectations in a relationship.

This sample template can be edited by the survey owner according to the required details about the respondent and to understand the health of the respondents relationship. Such a survey can be very useful especially for marriage counselors or psychiatrist to deduce various findings in a patient.

Some of the question examples of this questionnaire are “ How satisfied are you with your partner for the following in your relationship?, How fast are the issues resolved or forgiven?, et. al.

Below are the survey questions to determine the health of a relationship.

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Considering your experience in a relationship, how likely would you be to recommend a friend or a colleague to take this survey to understand the health of their relationship?

Very Unlikely

Very Likely

How satisfied are you with your partner for the following in your relationship?

	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied
Emotional support	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

Sex life	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

Financial support	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

Spontaneity	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

Time spent together	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

Respect and admiration received	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied

What is your gender?

Male

Female

other

Age?

Are you currently married?

Yes

How many years have you been together?

	Less than a year	1-4 years	4-7 years	7-10 years	10-15 years	15+ years
Married	Less than a year	1-4 years	4-7 years	7-10 years	10-15 years	15+ years

Not married	Less than a year	1-4 years	4-7 years	7-10 years	10-15 years	15+ years

How many children do you have?

What is the annual income?

	$25,000 or less	$25,000 - 50,000	$50,000 - 75,000	$75,000 - 100,000	$100,000 - $200,000	$200,000+
Yours	$25,000 or less	$25,000 - 50,000	$50,000 - 75,000	$75,000 - 100,000	$100,000 - $200,000	$200,000+

Your Partner's	$25,000 or less	$25,000 - 50,000	$50,000 - 75,000	$75,000 - 100,000	$100,000 - $200,000	$200,000+

What is the highest level of education?

	Less than high school	High School	Some college	College	Graduate school	Post graduate school
Yours	Less than high school	High School	Some college	College	Graduate school	Post graduate school

Your Partner's	Less than high school	High School	Some college	College	Graduate school	Post graduate school

Overall with the experience in your relationship, please rate for the below.

Professional life

	Yes	No
Are you currently working?	Yes	No

Is your partner currently working?	Yes	No

If either of you are not working at the moment, how long have you been unemployed?

Less than 1 month

1 - 6 months

7 - 12 months

1 - 2 years

2 - 3 years

3 - 4 years

5+ years

Do you and your partner share finances?

We have our own individual accounts

Some separate accounts but mostly shared

Mostly separate accounts but some shared

All are finances are shared

Who among you manages the finances, and decides if the expenses have to be cut?

Always the man

Always the woman

We manage and decide together

If you have a set budget for shopping, how much percent do you spend for each person?

Yourself

Your Partner

How often does an argument occur about the following with your partner?

	Daily	Weekly	Monthly	Few times a year	Rarely,	Never
Money	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Friends	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

In-laws or parents	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Household chores	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Children or pets	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Phone usage (WhatsApp, social media, online shopping etc)	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Each others appearances or dressing	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Responsibilities	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Time spent together	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

Intimacy	Daily	Weekly	Monthly	Few times a year	Rarely,	Never

How fast are your relationship issues resolved or forgiven?

Immediately

Next day

At least a week

Always hold a grudge

Does the person in the relationship has more power or dominance because he/she makes more money?

Definitely

Somewhat more

We still decide together

No the man still has more authority

How uncomfortable is it if the partner makes more money than the other?

Very uncomfortable

Somewhat uncomfortable

Not very uncomfortable

Not uncomfortable at all

If the man in the relationship makes less money than his partner, is he judged by the community around?

Very often

Sometimes

Rarely

Never

Please describe below, how does the age gap, educational qualifications or income, affect your relationship?

Who takes care of the following?

	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it
Cooking	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

Children	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

House cleaning	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

Financial analysis	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

Major decisions	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

Travel plans	Always the woman	Sometimes the woman	We share equally	Than man does it more often	Hired help does it

In your opinion, do you think that the man has to make more money than the woman?

Yes

Not necessarily

What happens after you fight?

We both dont talk to each other for sometime

There is verbal abuse

There is physical abuse

One of you leave the house for sometime

We talk to each other and apologize

Overall, how would you rate the health of your relationship?

Very Unhealthy

Very Healthy

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Relationship Survey Questions + Sample Questionnaire Template

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