Intimacy Questionnaire for Couples

Each question has four options, and couples can assign points based on their responses. Please answer honestly. This is designed to show you where you need to improve in intimacy with your spouse. 

1. Communication: How comfortable are you expressing your feelings with your partner?

 A) Very comfortable (4 points)

 B) Mostly comfortable (3 points)

 C) Occasionally comfortable (2 points)

 D) Rarely or never comfortable (1 point)

2. How often do you have deep, meaningful conversations with your partner?

A) Daily (4 points)

B) Weekly (3 points)

C) Monthly (2 points)

D) Rarely or never (1 point)

3. Emotional Connection: How understood do you feel by your partner?

A) Always (4 points)

B) Often (3 points)

C) Sometimes (2 points)

D) Rarely (1 point)

4. How often do you feel supported by your partner during tough times?

A) Always (4 points)

B) Often (3 points)

C) Sometimes (2 points)

D) Rarely (1 point)

5. Physical Intimacy: How satisfied are you with the level of physical affection in your relationship?

A) Very satisfied (4 points)

B) Satisfied (3 points)

C) Somewhat satisfied (2 points)

D) Unsatisfied (1 point)

6. How often do you and your partner engage in physical intimacy (hugging, kissing, etc.)?

A) Daily (4 points)

B) A few times a week (3 points)

C) A few times a month (2 points)

D) Rarely or never (1 point)

7. Shared Activities: How often do you spend quality time together doing activities you both enjoy?

A) Daily (4 points)

B) Weekly (3 points)

C) Monthly (2 points)

D) Rarely or never (1 point)

8. How connected do you feel when you engage in shared hobbies or activities?

A) Very connected (4 points)

B) Mostly connected (3 points)

C) Occasionally connected (2 points)

D) Rarely or never connected (1 point)

9. Trust and Safety: How much do you trust your partner with your personal thoughts and feelings?

A) Completely trust (4 points)

B) Mostly trust (3 points)

C) Somewhat trust (2 points)

D) Rarely or never trust (1 point)

10. How safe do you feel with your partner emotionally and physically?

A) Very safe (4 points)

B) Mostly safe (3 points)

C) Occasionally safe (2 points)

D) Rarely or never safe (1 point)

11. Conflict Resolution: How effectively do you and your partner resolve conflicts?

A) Very effectively (4 points)

B) Mostly effectively (3 points)

C) Sometimes effectively (2 points)

D) Ineffectively (1 point)

12. How often do arguments lead to a greater understanding between you and your partner?

A) Always (4 points)

B) Often (3 points)

C) Sometimes (2 points)

D) Rarely or never (1 point)

13. Future Goals: How aligned are your future goals and dreams with those of your partner?

A) Very aligned (4 points)

B) Mostly aligned (3 points)

C) Somewhat aligned (2 points)

D) Not aligned (1 point)

14. How often do you discuss your future together?

A) Daily (4 points)

B) Weekly (3 points)

C) Monthly (2 points)

D) Rarely or never (1 point)

15. Support: How often does your partner encourage you to pursue your personal goals and interests?

A) Always (4 points)

B) Often (3 points)

C) Sometimes (2 points)

D) Rarely or never (1 point)

16. How much do you feel your partner is a source of emotional support?

A) Very much (4 points)

B) Quite a bit (3 points)

C) Somewhat (2 points)

D) Not at all (1 point)

17. Presence: How present and attentive do you find your partner when you need them?

A) Very present (4 points)

B) Mostly present (3 points)

C) Occasionally present (2 points)

D) Rarely or never present (1 point)

18. How often do you feel that your partner prioritizes your relationship over other commitments?

A) Always (4 points)

B) Often (3 points)

C) Sometimes (2 points)

D) Rarely or never (1 point)

19. Affection and Appreciation: How regularly do you express love and appreciation towards each other?

A) Daily (4 points)

B) Weekly (3 points)

C) Monthly (2 points)

D) Rarely or never (1 point)

20. How valued and appreciated do you feel by your partner?

A) Very valued (4 points)

B) Mostly valued (3 points)

C) Occasionally valued (2 points)

D) Rarely or never valued (1 point)

Scoring

76-80 points: Extremely intimate and connected relationship.

61-75 points: Strong level of intimacy with room for growth.

46-60 points: Moderate level of intimacy; consider areas for improvement.

30-45 points: Low level of intimacy; focus on rebuilding connection.

Below 30 points: Very low level of intimacy; seek professional advice or counseling.