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Relationship Satisfaction & Connection Check-In

Measures how satisfied partners are with communication, intimacy, trust, and shared responsibilities in their relationship, with an AI follow-up that digs into the specific moment or pattern behind their lowest-rated area rather than settling for a generic label.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全13問・約7分
Q01
メッセージ

Thanks for taking a few minutes to reflect on your relationship. This check-in covers communication, trust, intimacy, and day-to-day teamwork — there are no right answers, just your honest experience. About 5-6 minutes.

Q02
オピニオンスケール必須

Overall, how satisfied are you with your relationship right now?

スケール: 0 – 10
最小:Not at all satisfied最大:Extremely satisfied
Q03
マトリクス必須

How satisfied are you with each of these areas of your relationship?

7行 × 5列
  • Communication
  • Trust
  • Emotional intimacy
  • Physical intimacy
  • Division of chores/responsibilities
  • ほか2件
列: Very dissatisfied · Dissatisfied · Neutral · Satisfied · Very satisfied
Q04
選択式必須

In the last 30 days, how often did you and your partner have a meaningful conversation (not just logistics) about your relationship or feelings?

  • Not at all
  • Once or twice
  • Weekly
  • Several times a week
  • Almost daily
Q05
選択式必須

In the last 30 days, how did most disagreements between you and your partner typically end?

  • Resolved with both feeling heard
  • Resolved but one side gave in
  • Left unresolved but dropped
  • Escalated or repeated later
  • We had no disagreements
Q06
評価スケール必須

How would you rate your partner's effort in making you feel valued and appreciated?

範囲: 1 – 5
最小:Very low effort最大:Very high effort
Q07
ランク付け

Rank these areas from most to least in need of improvement in your relationship right now.

  1. Communication
  2. Trust
  3. Emotional intimacy
  4. Physical intimacy
  5. Sharing responsibilities
  6. Handling conflict
  7. Quality time together
ドラッグして順位を付ける
Q08
選択式必須

Thinking about the next year, how do you feel about the future of this relationship?

  • Very optimistic
  • Somewhat optimistic
  • Uncertain
  • Somewhat pessimistic
  • Very pessimistic
Q09
AIインタビュー

Identify the respondent's lowest-rated area from the satisfaction battery and reconstruct a specific recent moment tied to it — what happened, how each partner responded, and what they wished had gone differently. If they rated everything highly, probe instead for one thing that could still quietly become a problem if unaddressed, anchoring on a concrete recent example rather than a general feeling.

Q10
自由回答（長文）

Is there anything about your relationship you haven't had a chance to say here that feels important to add?

Q11
選択式

How long have you and your partner been together?

  • Less than 6 months
  • 6 months to 2 years
  • 2 to 5 years
  • 5 to 10 years
  • More than 10 years
  • Prefer not to say
Q12
選択式

What is your relationship status?

  • Dating
  • Living together
  • Engaged
  • Married
  • Other
  • Prefer not to say
Q13
メッセージ

Thank you for reflecting so openly. Your responses will be combined with others (anonymously, if part of a group study) to highlight patterns in relationship strengths and areas worth extra attention.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Goes beyond a satisfaction score by using an AI follow-up interview that targets the respondent's specific lowest-rated area and asks about the actual moment or pattern behind it, rather than stopping at a generic label
  • Covers the full relationship picture in one flow: a satisfaction matrix across communication, intimacy, trust, and shared responsibilities, plus conversation frequency, disagreement style, partner effort, and a forward-looking outlook question
  • Includes a ranking question so respondents prioritize which areas most need improvement, giving structure the AI follow-up can act on
  • Ends with an open-ended long-text prompt so respondents can add anything the structured questions didn't capture, alongside a transparent closing message about how responses will be used

Jotform

Relationship Satisfaction Survey Form Template

A ready-to-use, static form template covering relationship satisfaction that can be customized with Jotform's form builder and integrated with its broader ecosystem (payments, notifications, etc.). It's a fixed question set rather than an adaptive interview, so every respondent sees the same questions regardless of their answers.

優れている点

  • Fielding-ready template usable immediately without survey design work
  • Benefits from Jotform's mature drag-and-drop form builder and integrations
  • Easy to embed or share via link, common for personal or coaching use cases

物足りない点

  • Static question set with no adaptive follow-up into a respondent's lowest-rated area
  • No automated per-response quality scoring or AI-generated analysis reports
  • No voice AI interview option or guided task/screen-share capability

SurveySparrow

Relationship Satisfaction Survey Template Online

A conversational-style survey template that presents relationship satisfaction questions one at a time, which reads more naturally than a traditional grid form. It's still a predefined script, though, so it can't probe deeper based on what a specific respondent says about their lowest-rated area.

優れている点

  • Conversational one-question-at-a-time UI that feels less clinical than a standard form
  • Fielding-ready template available immediately in SurveySparrow's library
  • Supports basic branching logic within its no-code builder

物足りない点

  • No true adaptive AI interviewer digging into the specific moment or pattern behind a low score
  • No transparent, publishable prompt methodology or automated quality scoring per response
  • No voice AI interview mode or guided screen-share task option

よくあるご質問

「Relationship Satisfaction & Connection Check-In」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes to reflect on your relationship. This check-in covers communication, trust, intimacy, an…」・「Overall, how satisfied are you with your relationship right now?」・「How satisfied are you with each of these areas of your relationship?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、13問を約7分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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