PREMARITAL COUNSELING QUESTIONNAIRE FOR LADIES

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					PREMARITAL COUNSELING QUESTIONNAIRE FOR LADIES

Today’s Date: _______________

(Feel free to write out any further explanation to any question.)

Name: __________________________________                        Birthday _____________

Date of Marriage: _________________________

   1. On a scale of 1 to 10 (10 being superb and 1 being terrible) how would you rate your
      relationship with God? __________

   2. On the same scale, how would you rate your relationship with your parents? __________

   3. Do you make time daily for personal Prayer and Bible Reading? Yes            No

   4. How many times in a week (besides meals) do you and your family have Prayer and
      Bible Reading together? __________               You and your fiancé? __________

   5. Are you a woman that keeps her word? __________

   6. Will you be truly committed to your marriage vows “till death do you part” no matter
      what happens in your marriage?      Yes No

   7. Will divorce ever be an option for you?            Yes    No

   8. (Circle One) I feel I     am        am not         a teachable person.

   9. Circle the areas that feel may become problem areas in your marriage:

               Finances         In-laws            Sex          Communication

   10. Do your parents feel that you have a problem with submission? __________

   11. I       do      do not             know how to cook good meals.

   12. I prepare my family’s favorite foods:

       Never           Seldom             Occasionally          Regularly

   13. I praise other family members in the presence of others:

       Never           Seldom             Occasionally          Regularly
   14. I submit to my parents:
       Never          Seldom          Occasionally           Regularly

   15. I have a sweet spirit:

       Never            Seldom        Occasionally           Regularly

   16. I nag:

       Never            Seldom        Occasionally           Regularly

   17. My room is:

                Clean           Halfway Clean        Dirty           Cluttered      Organized

   18. Mark the sentence that best describes you and how you feel about babies and children:
       _____ “Children are a nuisance I don’t want to fool with.”
       _____ “Children are such a great responsibility I don’t want to take the risk.”
       _____ “Children are nice but one or two would be plenty for me.”
       _____ “Children are a great blessing and the husband and wife with several of them have
       been favored by the Lord”

   19. I feel my future husband and I will           agree           disagree       on disciplining
any children.

   20. I look at my parent’s eyes when they are talking to me:

       Never            Seldom        Usually        Always

   21. If I could choose, I would rather be a        career-lady            wife & mother

   21. My view of sex in marriage is that it should be:

                Nonexistent           Occasional             Regular & Satisfying

   22. If I could change one thing about my fiancé it would be:




   23. Our relationship with my family (Parents, etc.) is:   Good           Fair            Poor

   24. Our relationship with my fiancés family (Parents, etc.) is:   Good           Fair      Poor
25. If there is one thing I need to change it is probably:




26. Mark the statement(s) that best describe how you forgive:
            “I don’t forgive easily at all.”
            “I may forgive but I don’t forget.”
            “I try to forgive but am not always successful.”
            “I forgive completely because I know that God has forgiven me more that anyone
    else could do to me.”

27. I love money: True     False

28. I give 10% of my income to God:

    Never          Seldom          Usually         Always

29. I fantasize about other men:

    Never          Seldom          Usually         Always

30. I usually spend “extra” time ____________________________________

31. I have the following good habits:




32. I have the following bad habits:




33. My fiancé has the following good habits:




34. My fiancé has the following bad habits:
   35. I       Have           Have Not       been immoral before today.


Your answers will be held in confidence. Feel free to tell the Pastor if you feel the knowledge of
some answer would hurt your relationship with your future mate.