Clinical psychologist offering therapeutic
services for life, love, marriage & divorce

(310) 720-4373

Relationship Check Up

It is very difficult or impossible to communicate in my relationship
- True
- False
I feel I don’t get my needs met in my relationship
- True
- False
I often wonder if there is someone better out there
- True
- False
I feel like I don’t have anything in common with my partner
- True
- False
I don’t trust my partner
- True
- False
I am afraid of losing my partner
- True
- False
My partner doesn’t make me a priority
- True
- False
I envy other relationships around me
- True
- False
There is very little or no physical intimacy in my relationship
- True
- False
There is very little or no emotional intimacy in my relationship
- True
- False
I don’t feel safe expressing my feelings in my relationship
- True
- False
I often think about ending my relationship
- True
- False
When my partner and I fight we say hurtful things
- True
- False
I feel I have outgrown my partner and the relationship
- True
- False
I want to end the relationship but don’t know how
- True
- False
If you answered true to one of these questions you and your relationship would greatly benefit from threrapy.
Name*
FirstLast
Email*
Phone
I would like to hear more about therapy services
- Yes
- No

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California Licensed Therapist no: PSY22901