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PLEASE FILL OUT THE FORM BELOW. BOTH YOU AND/OR YOUR PARTNER MUST FILL OUT THIS FORM PRIOR TO YOUR CONSULTATION. ALTHOUGH IT IS NOT REQUIRED FOR BOTH PARTNERS TO FILL OUT THIS FORM PRIOR TO THE CONSULTATION, IT IS HIGHLY RECOMMENDED. 

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REQUIREMENTS

1. My requirements are met.
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Completely
2. My vision is supported.
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3. My mission and purpose are supported.
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4. I'm willing to live the rest of my life with everything exactly as it is in this relationship.
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5. I am not settling for less than I really want by choosing this relationship.
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6. We are in alignment about money.
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7. We are in alignment about future plans.
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8. We are in alignment about children and family.
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9. This relationship is addiction-free.
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10. I trust my partner to be sexually faithful.
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11. I trust my partner with my/our money.
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12. I trust my partner to be honest with me about everything.
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13. I trust my partner to keep agreements in this relationship.
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14. I can see myself growing old and happy in this relationship.
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15. I feel physically safe in this relationship.
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LIFESTYLE

16. We are in alignment about our lifestyle.
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17. We are well-matched in our food preferences and eating habits.
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18. We are well-matched in our health habits and practices.
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19. We are well-matched in our grooming and hygiene habits and practices.
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20. We are well-matched in our hobbies, physical, and leisure activities.
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21. We are well-matched in our level of desire for travel and adventure.
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22. We are well-matched in our preferences to stay home and have quiet times.
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23. We travel well together.
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24. I am supported to pursue my own interests/activities in this relationship.
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COMMUNITY

25. Our families support our relationship.
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26. Our kids support our relationship.
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We don't have children.
27. Our friends support our relationship.
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28. We are well-matched in our preferences for socializing with friends and family.
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29. We both have individual support systems.
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30. We seek support when we need it.
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EMOTIONAL NEEDS

31. I feel loved in this relationship.
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32. I feel good about myself in this relationship.
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33. This relationship brings out the best in me.
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34. I feel emotionally safe in this relationship.
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35. I feel able to be myself in this relationship.
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36. I feel respected for who I am in this relationship.
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37. We have equal levels of give and take in this relationship.
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38. I have fun and laugh in this relationship.
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39. This relationship feels equal on all levels.
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40. We enjoy small moments of connection each day no matter how busy we are.
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SPIRITUALITY

41. We are in alignment about religious and/or spiritual beliefs and practices.
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42. Our values are well-matched.
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43. We are well-matched in our desire to make a difference in the world.
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44. We support each other's hopes, dreams, and aspirations.
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45. We recognize and support each other's "essence" in times of stress.
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RELATIONSHIP SKILLS

46. Our communication is effective.
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47. We manage our differences positively and without conflict.
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48. I am able to be totally honest in this relationship.
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49. We handle stress effectively in this relationship.
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50. We handle differences and conflict effectively without "fight or flight."
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51. We soothe ourselves and each other in tense situations.
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52. We are able to live positively with our unsolvable differences.
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53. We respect each other's feelings and reactions during conflict.
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54. We regularly discuss small frustrations and irritations so they don't get larger.
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55. We try to make things better during or after a conflict.
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56. We forgive each other and don't hold onto resentments.
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HOUSEHOLD RESPONSIBILITIES

57. We are in alignment about pets.
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58. We are in alignment about how to handle kids.
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59. We are in alignment about who does what around the house.
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60. We are in alignment about our level of organization/neatness around the house.
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61. We share equally in caring for our home.
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61. We share equally in caring for our home.
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SEXUALITY

62. I experience strong chemistry in this relationship.
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63. I experience passion in this relationship.
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64. I experience romance in this relationship.
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65. I find my partner very attractive.
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66. I get turned on with my partner.
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67. I know what turns my partner on.
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68. We talk about our sexual preferences and needs.
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69. I am sexually fulfilled in this relationship.
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PERSONALITY/DEVELOPMENT

70. We are well-matched intellectually.
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