This questionnaire is designed to help you reflect on how functional (healthy) your close romantic relationship is. Answer each statement honestly based on your current or most recent relationship. There are no right or wrong answers.

Use this scale for every item:
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree

If you are not in a relationship right now, answer based on your most recent significant relationship.

Core connection (Items 1–9)

  1. I feel emotionally safe sharing my true thoughts with my partner.

  2. My partner treats me with respect even when we disagree.

  3. I can trust what my partner tells me.

  4. I feel valued and appreciated in this relationship.

  5. We have a generally stable, predictable relationship rather than constant drama.

  6. I do not feel like I am “walking on eggshells” around my partner.

  7. We both protect each other’s dignity (no public shaming or humiliation).

  8. I believe my partner is fundamentally “on my side.”

  9. We are honest with each other about important matters.

Communication patterns (Items 10–18)

  1. We can talk openly about difficult topics without the conversation exploding.

  2. My partner listens to me without interrupting or dismissing my feelings.

  3. We work together to solve problems instead of attacking each other.

  4. When we argue, we eventually calm down and try to understand each other.

  5. I feel heard and understood in most of our conversations.

  6. We can express disagreement without name‑calling or insults.

  7. We are able to come back and repair things after a conflict.

  8. I do not feel like my partner constantly criticizes or blames me.

  9. We can compromise when we have different opinions.

Power and boundaries (Items 19–27)

  1. Decisions in this relationship are generally made together.

  2. I feel free to say “no” without being punished or guilt‑tripped.

  3. Neither of us tries to control where the other goes or who they see.

  4. My partner respects my personal boundaries and limits.

  5. We both have a say in major financial or life decisions.

  6. Jealousy does not control our relationship.

  7. I do not feel dominated or overpowered by my partner.

  8. We each have some individual time, friends, or interests without it becoming a big issue.

  9. My partner and I can influence each other’s decisions in a balanced way.

Intimacy and affection (Items 28–33)

  1. Affection (hugs, kind words, touch) is a regular part of our relationship.

  2. I feel emotionally close to my partner.

  3. Our sexual relationship (if applicable) feels mutual and respectful, not pressured.

  4. We enjoy spending time together and sharing activities.

  5. My partner does not withhold affection as a way to punish me.

  6. I feel comfortable being vulnerable (for example, sad or afraid) with my partner.

Responsibility and growth (Items 34–39)

  1. When conflicts occur, both of us can admit our part in the problem.

  2. My partner is willing to apologize when they are wrong.

  3. I am willing to apologize when I am wrong.

  4. We encourage each other’s personal growth and goals.

  5. We try to learn from past mistakes instead of repeating the same unhealthy patterns.

  6. We can adjust and be flexible when life circumstances change.

Harmful patterns and red flags (Items 40–45)
(Reverse‑scored; see scoring key.)

  1. My partner often makes me feel crazy or questions my memory of what happened.

  2. One of us regularly uses threats, intimidation, or fear to get their way.

  3. Our conflicts often involve yelling, name‑calling, or vicious put‑downs.

  4. One of us often uses guilt, silent treatment, or emotional blackmail to control the other.

  5. Substance use, screen use, or other addictions regularly damage our relationship.

  6. I have felt afraid for my physical safety in this relationship.

Scoring Key

  1. For Items 1–39 (functional items):

  • Add your answers for all items 1–39.

  • Higher scores indicate more functional, healthy patterns.

  1. For Items 40–45 (harmful items – reverse score):

  • First, reverse each response:

    • If you answered 1 → score as 5

    • 2 → 4

    • 3 → 3

    • 4 → 2

    • 5 → 1

  • Add the reversed scores for items 40–45.

  • Higher reversed scores indicate fewer harmful patterns.

  1. Total Functional Relationship Score:

  • Add:

    • Sum of Items 1–39

    • Plus the reversed‑score sum of Items 40–45

  • Possible range: 45–225.

Interpretation (for reflection, not diagnosis):

  • 180–225: Many healthy, functional patterns; keep nurturing strengths.

  • 135–179: Mixed; some good patterns, some concerns to work on.

  • 90–134: Significant dysfunction; consider seeking support.

  • 45–89: High risk; serious patterns that may require professional help and, if there is any abuse, safety planning.