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


I embody these qualities myself (choose one) _____yes  _____ no _____somewhat

My 3 best qualities that I bring to relationships are:






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 




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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Betsy Finders RN,CH, Certified Healer Modern Mystery School

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