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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.


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
Sex life
Financial support
Spontaneity
Time spent together
Respect and admiration received
What is your gender?
Age?
18-25
26-33
34-41
42-51
52-61
62-75
75+
Yours
Your Partner's
Are you currently married?
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
Not married
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
Your Partner's
What is the highest level of education?
Less than high school
High School
Some college
College
Graduate school
Post graduate school
Yours
Your Partner's
Overall with the experience in your relationship, please rate for the below.
 
Lowest
Highest
1
2
3
4
5
6
7
8
9
10
Chances that you or your partner will eventually break up or divorce
Professional life
Yes
No
Are you currently working?
Is your partner currently working?
If either of you are not working at the moment, how long have you been unemployed?
Do you and your partner share finances?
Who among you manages the finances, and decides if the expenses have to be cut?
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
Friends
In-laws or parents
Household chores
Children or pets
Phone usage (WhatsApp, social media, online shopping etc)
Each others appearances or dressing
Responsibilities
Time spent together
Intimacy
How fast are your relationship issues resolved or forgiven?
Does the person in the relationship has more power or dominance because he/she makes more money?
How uncomfortable is it if the partner makes more money than the other?
If the man in the relationship makes less money than his partner, is he judged by the community around?
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
Children
House cleaning
Financial analysis
Major decisions
Travel plans
In your opinion, do you think that the man has to make more money than the woman?
What happens after you fight?
Overall, how would you rate the health of your relationship?
Very Unhealthy
Very Healthy

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