Couples Survey Questions

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My First Name*

My Last Name*

My Email*

Partner's Name*

Counselor's Email*

If you don't have it, please input support@impact.vision, and we will direct it to them.

My Phone*

Partner: 10-20 years vision*

Mine: 10-20 years vision*

Partner: Favorite foods*

Mine: Favorite foods*

Partner: How Do They Deal With Stress*

Mine: How Do They Deal With Stress*

Partner: What Is Their Pet Peaves*

Mine: What Is Their Pet Peaves*

Partner: What Do They Get Irritated About Most*

Mine: What Do They Get Irritated About Most*

Partner: Anger Level And Why (1 Weak And 10 Strong)*

Mine: Anger Level And Why (1 Weak And 10 Strong)*

Partner: What Turns Them On Romantically*

Mine: What Turns Them On Romantically*

Partner: Spiritual Maturity & Why? (1 Weak And 10 Strong)*

Mine: Spiritual Maturity & Why? (1 Weak And 10 Strong)*

Partner: Most Top 3 Traumatic Childhood Experiences*

Mine: Most Top 3 Traumatic Childhood Experiences*

Partner: Political Party Affiliation And Views*

Mine: Political Party Affiliation And Views*

Partner: Addictions/Bad Habits That Will Most Likely Affect You In Future?*

Mine: Addictions/Bad Habits That Will Most Likely Affect You In Future?*

Partner: Favorite Movies, Songs, And Books?*

Mine: Favorite Movies, Songs, And Books?*

Partner: Who Are The Most Influential People In Your Partner's Life?*

Mine: Who Are The Most Influential People In Your Partner's Life?*

Partner: What Inner Fears Are Driving Them*

Mine: What Inner Fears Are Driving You*

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