• Couples Questionnaire

  • Instructions:

    Please be thorough in your answers. If you need to stop midway through this questionnaire and finish it later, click on the link at the very bottom that says "Save and Continue Later" (next to the Submit button).

    You must answer every question. If a question does not apply to you, just answer NONE or N/A, or provide a minimal response of some kind, so that the form will allow you submit your responses.

    When you have completed all the of questions in the questionnaire, click the Submit button at the very bottom.