BraveHeart Questionnaire

BraveHeart Questionnaire

Instructions:

1. Please take some space to fill in the following questionnaire.

2. Please do so yourself, without consulting with your partner.

3. Keep your answers concise.

PLEASE NOTE: Your answers will be kept confidential and will not be shared with the group or your spouse.

Name *

First

Last *

Last

Why did YOU choose to come on this couples retreat? *

What do YOU think your greatest challenge is in your relationship at the moment? *

What one thing would you like your partner to change? *

What one thing do you think your partner would like to change about you? *

What one thing would you like to get from the retreat? *

Has children (if you have them) brought you closer together or kept you apart somehow? *

What personal challenge do YOU have that impacts your relationship? *

How does it impact your relationship? *

Is there anything else you would like to add that you feel is important? *

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