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Impact Quiz - Pre Course

We’ve designed a simple online quiz to measure your sense of relational contentment. The ‘Impact Quiz’ takes about 3 minutes to complete and we’ll cue you to do it at different stages of the course: at the beginning, at the conclusion and six months later. It's completely optional and your privacy is absolutely protected.

"*" indicates required fields

Step 1 of 13

Part I

Thinking about your relationship in the past week (if it wasn't a typical week, answer in terms of a typical week in the past month)...

1. How would you rate your personal contentment in your relationship?*

Very Discontented	Discontented	Neutral	Contented	Very Contented

2. How often did you think that things were going well between you?*

Never or rarely	Sometimes	Mostly	Always

3. How safe and at ease did you feel in your relationship?*

Never or rarely	Sometimes	Mostly	Always

4. How often did you feel hurt or disappointed in your relationship?*

Never	Once or twice	Almost daily	Lost Count

5. How often did you connect on a significant level?*

Never	Once or twice	Almost daily	Lost Count

6. How often did you laugh or have fun together?*

Never	Once or twice	Almost Daily	Lost Count

7. How often did you have time together (of 10+ mins) for just the two of you?*

Never	Once or twice	Almost daily	Lost Count

8. How equitable do you think your relationship is (ie both are contributing)?*

None	A Little	Acceptable	Good

9. How often did you argue or disagree?*

None	Once or twice	3-4 Times	Every day	Lost Count

10. How many positive to negative interactions did you have?*

Only Negative	Mostly Negative	About Even	Mostly Positive	Only Positive

11. How often were you physically intimate (sex, kissing, caressing, other non-genital touch etc)?*

Never	Once	Twice	Three times	Four times	Lost Count

Part 2

Thinking about yourself in the past week…

12. How often did you make a gesture of kindness or service towards the other?*

None	Once	Twice	3-4 Times	Every day	More than Daily

13. How often did you express affection towards the other?*

None	Once	Twice	3-4 Times	Every day	More than Daily

14. How often did you express gratitude and appreciation to the other?*

None	Once	Twice	3-4 Times	Every day	More than Daily

15. How often did you speak or act in anger towards the other?*

None	Once	Twice	3-4 Times	Every day	More than daily

16. How often did you criticise or negatively judge the other?*

None	Once	Twice	3-4 Times	Every day	More than daily

17. How often were you dishonest with the other (withheld information, kept a secret, misled or lied)?*

None	Once	Twice	3-4 Times	Every day	More than Daily

18. How much did you grow or develop as a person?*

Went Backwards	No Growth	Grew a Little	Grew a Lot

19. How committed are you to becoming a better husband/wife?*

Not at all	Somewhat	A little	Totally

20. How hopeful are you with regards to the future of your relationshiip?*

Total Despair	Despair	Cautiously Hopeful	Extremely Hopeful

Your Sex*

Male

Female

Relationship Status*

Dating

Cohabitating/Defacto

Engaged

Married

Remarried

Separated

Divorced

Other

Sexual Status*

Please select the one that best describes your relationship.

Pre-sexual - some physical intimacy but no intercourse

Sexual - includes genital intercourse

Post-sexual - were previously sexual but are not currently so.

Other

What SmartLoving course are you starting?*

Discern

Engaged

Fertility

Sponsor

Newlywed

Marriage Kit

Breakthrough

Theology

Other

Would you like a copy of your answers sent to you by email?

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Impact Quiz - Pre Course

Part I

Part 2

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