1. What statement best describes you?
A deeply feeling person
A talkative-sharing person
A doing-showing person
2. The thing I remember receiving most in my childhood was...
Affection
Verbal Praise
Rewards
3. The family I grew up in demonstrated love by...
Touching
Telling
It was just understood
4. A a child, I remember being... (If none of these things happened, which one would you have feared the most?)
Spanked
Yelled at
Grounded
5. People need to be more considerate of...
Other people's feelings
How they speak to each other
Other people's time and schedules
6. In communicating affection to my Significant Other, I prefer to...
Give tender kisses
Express tender words
Give a gift of tender meaning
7. I would most enjoy receiving from my companion...
A hug and a kiss
An opportunity to talk about the day's events
A phone call during the day
8. For a small gift, I would most enjoy receiving...
A coupon that said "Good for one back rub or foot massage"
A personal handwritten letter expressing appreciation
A chance to work with my spouse on a favorite project
9. I am most frustrated by...
Insensitive people
Critical people
Unfair people
10. I need to spend more time with my Significant Other talking about...
Positive things
Significant events
Alternatives and solutions
11. I would prefer...
Walking hand in hand
A positive heart-to-heart talk
A clean house or well-kept yard
12. It is more important to have my Significant Other...
Sit next to me...
Talk about my hopes and dreams
Remember to run an errand for me
13. I would rather be...
embraced and treated affectionately
told that I am loved
Shown that I am loved
14. What I admire in a friend is...
Unconditional acceptance
Availability and understanding
Loyalty and dependability
15. I would prefer to have my Significant Other...
Reach out and touch me
Say I love you
Surprise me with a good deed
16. My idea of a great weekend is...
Spending time just being together
Visiting with friends and family
Getting lots of projects accomplished
17. I would prefer receiving appreciation by...
A hug
A kind word
Receiving something I loved
18. With which of these statements would you most agree?
I would rather hold hands in public or walk arm-in-arm and mean it than live in a fancy house.
I would rather be told I was loved than be married to a workaholic who is always giving me everything but himself or herself.
You shouldn't have to tell people you love them; they should know it by the way they're treated.
19. The thing that upsets me most about children is their...
Not being affectionate
Talking back
Not being obedient
20. The thing that upsets me most about my loved one is their...
Lack of intimacy
Failure to communicate
Lack of responsibility
21. I would rather have my Significant Other...
Be physically expressive in touching
Recognize my efforts with words of appreciation
Demonstrate appreciation by something I can see
22. When I get upset as a parent, I am more inclined to... (We are talking about being reasonable in all of this, not abusive behavior.)
Spank
Scold
Withdraw privileges
23. As a parent of a young child, I would prefer... (It's not about what you think they would like, it's what you would prefer to do.)
Holding or wrestling with them
Reading a story to them
Taking them to a park
24. I feel good...
Just being held
Being able to fully express myself
Getting things done
25. Which best describes you?
Physically expressive
Verbally expressive
Accomplishment oriented
26. As a sign of caring for me, I would like to receive from a loved one...
Lots of affection
Sincere praise
Hands-on help
27. I would prefer to have my Significant Other...
Spend more one-on-one time with me
Pay me a compliment
Show greater participation in doing daily tasks
