Soul Mate Questionnaire
Your Soul Mate’s Ready, Are you?
Fulfill Your Heart’s Destiny
Name: Date:
(A) Circle the 3 most important qualities you want in your mate:
Open Attractive Truthful Kind Responsible Committed Loving Faithful Adventurous Sensual Creative Abundant Confident Integrity Dependable Spiritual Sense of humor Emotionally Available Physically Available
Others:_______________________
I embody these qualities myself (choose one) _____yes _____ no _____somewhat
My 3 best qualities that I bring to relationships are:
1)
2)
3)
My definition of a soul mate……
(B) ___I am “somewhat” involved and have been for ___mo/yr
___I’m no longer with my ex but feel part of myself thinking about what could have been if only_________________________________________.
I’m currently alone and have been for ____mo/yr
Being on my own is:
___Great ___Okay ___Lonely ___Scary ___The Pits
(C) Did you have any of these challenges/experiences in your childhood? (write in ages)
_____Divorce _____Abuse _____Death of someone close _____ Adoption
_____Serious Illness _____Alcoholic Parent _____Drug Abuse
Distant Parent(s)_____ Other trauma___________________________
My past relationships ended because of:
____ Lack of commitment
____ My partner left me
____ Fear of intimacy
____ The fire went out
____ Abuse
____ Other:____________________
____I ____my partner ended my last relationship.
This is a pattern for me _____yes _____no
I was reactive (had my buttons pushed) and felt it wasn’t fair ____often____sometimes ________rarely in my past relationships.
I feel I lose myself in relationships ____yes ____some ____no
(D) In relationships I’m better at (choose one):
_____ giving love
_____ receiving love.
I love from my Head (idea of love) __ or I love from my Heart (allow someone in)___
(E) How I want my Soul Mate relationship to be different from my last several relationships……
How I acted in my past relationships that I do not want to repeat with my Soul Mate……
(F) I (choose one) ____rarely _____sometimes_____always trust the opposite sex.
I’m good at being truthful with my partner (choose one) _____yes _____no ___Sometimes
(G) Do you feel that part of you doesn’t believe you can have the mate you desire? _____
What “doubts” do you hear about having your Soul Mate from your “Voice of Doubt”? Select all that apply.
____ It doesn’t exist
____ I’ll lose myself
____ I’m not attractive enough
_____ All the good ones are taken
_____ They’re all too immature
_____ It’s too much trouble
_____ I’ll be controlled
_____ They’ll leave or die
_____ It’ll just be like the last one
_____ I’ll have to give up more than I get
_____ I had “the One” and lost him/her
_____ It’s easier to be alone
Others__________________________________________________
I feel my Soul Mate isn’t with me because……..
I’m fully committed to finding my Soul Mate _____yes _____no
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