Brain in Love Questionnaire

June 17, 2011

When your brain is the one in love then it has to do more with your mind being in love.  It means that your love is rational and well thought out.  You brain falling in love means that your consciousness has connected with another person in the rational part of your body which is the brain.  There are questionnaires available which can help you determine whether yours is a rational love or not.  In a survey trying to find out people’s feelings a questionnaire can come in handy.  It can help you decide whether your love should lead into marriage.

Your name: ____________________________________

Occupation: ____________________________________

Age group: _____________________________________

Location: _______________________________________

Economic status: _________________________________

Your partner’s name: ______________________________

Occupation: ________________

Age group: _______________

Location: _________________

Economic status: ___________

Please rate the following aspects about your relationship with very compatible, compatible, moderate, not very compatible, incompatible.

Hobbies: _________________

Interests: _________________

Dreams: __________________

Goals: _____________________

Aspirations: _________________

Family issues: ________________

Money issues: ________________

Plans for the future: ____________

Religion: __________________

Where to live: _______________

Please rate the following aspects about your relationship with excellent, good, average, poor, very poor.

Commitment: ___________________

Intimacy: ________________________

Communication: ___________________

Romance: _________________________

Passion: ___________________________

Attraction: __________________________

Please describe the hobbies you have in common with your partner:

________________________________

Please describe the interests that you have in common with your partner:

______________________________

Please describe the issues that bring problems into your relationship:

___________________________________

Please describe some of the ways you resolve conflict in your relationship:

_________________________

Additional comments:

______________________

Download Brain in Love Questionnaire in Word Format

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