About this template
Understanding interpersonal dynamics is essential for effective counseling and relationship coaching. This Relationship Satisfaction Survey template helps therapists, counselors, and relationship consultants gather structured insights into how partners perceive their connection, communicate, and align on future expectations.
The questionnaire begins with foundational background information such as demographic details and the history of the relationship. It then transitions into rating scales and true-or-false statements designed to measure trust, emotional fulfillment, conflict resolution, and overall satisfaction. Practitioners can easily deploy this form before an initial consultation or as a periodic check-in to track progress over time.
Built for seamless digital collection via Doc2Form, this template eliminates paper clutter and lets you review responses directly in Google Sheets. Whether you run a private practice or facilitate workshops, this ready-to-use survey streamlines client assessment so you can focus on meaningful dialogue.
Key features
- Pre-built sections covering demographics, history, and satisfaction scales.
- Easily customizable questions to fit your specific therapeutic framework.
- Collect responses securely directly into Google Sheets for quick review.
- Mobile-friendly design for easy completion by clients before sessions.
- Save hours of form building with a clean, professional layout.
Use cases
- Initial intake and assessment for couples counseling sessions.
- Pre-marital counseling evaluations and expectation alignment.
- Periodic relationship check-ins for ongoing therapy clients.
- Research and feedback collection for relationship workshops or retreats.
What this form collects
- Today's Date (Date)Enter the current date.
- Gender Identity (Dropdown)Select the option that best describes your gender identity.
- Age (Short answer)Enter your current age in years.
- How long have you known each other? (Short answer)Specify the duration (e.g., 3 years, 6 months).
- Length of Relationship (Short answer)How long have you been in a committed relationship together?
- We communicate our feelings openly and honestly. (Linear scale)Rate your level of agreement from 1 to 5.
- We resolve conflicts constructively without hostility. (Linear scale)Rate your level of agreement from 1 to 5.
- We share common goals and values for the future. (Linear scale)Rate your level of agreement from 1 to 5.
- I feel deeply supported and appreciated by my partner. (Linear scale)Rate your level of agreement from 1 to 5.
- We spend enough quality time together. (Multiple choice)Select True or False.
- Financial matters are a constant source of stress between us. (Multiple choice)Select True or False.
- We trust each other completely. (Multiple choice)Select True or False.
- Additional Thoughts (Paragraph)Please share any other concerns, goals, or topics you would like to address during counseling.
FAQ
What is a Relationship Satisfaction Survey?
It is a structured questionnaire used by therapists and counselors to evaluate the emotional health, communication patterns, and overall satisfaction within a relationship.
Who should use this template?
This form is ideal for licensed marriage and family therapists, clinical psychologists, relationship coaches, and professional counselors.
Can I customize the questions?
Yes! Once you generate the form in Google Forms, you can fully edit, add, or remove any questions to align with your practice's methodology.
How do I share this survey with clients?
You can email a direct link, embed the form on your secure practice website, or send it as part of your onboarding workflow.
Where are the survey responses stored?
All responses are saved securely in your connected Google Drive and Google Sheets, giving you instant access to client data.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.