Okay, here it is. I got it done last night but then my computer kicked me off the internet, sorry for the delay.

Weber State University Research Study

Thank you for your participation in this research study. All answers will be kept strictly confidential. Although you may skip any question you feel uncomfortable with, your full and complete cooperation is appreciated. This survey will be used in a research project designed to understand couple communication more effectively. Though we encourage you to discuss this questionnaire with your significant other, we ask that you do not discuss any answers until it is completed.

Please circle one.

How old are you? 18-25 25-35 35-45 45-55 55-older

What is your sex? Male Female

What is your yearly net household income? 0-20K 20K-40K 40K- 60K 60K-80K 80K-Up

What is your main ethnicity? African-American Asian Caucasian Latino Native-American other_______

If married, how many years have you been with your current spouse? _______


Most persons have disagreements in their relationships please indicate below the approximate extent of agreement or disagreement between you and your partner for each item on the following list.

1.) Philosophy of life____
2.) Aims, goals, and things believed important____
3.) Amount of time spent together____

5 4 3 2 1 0
Always Almost Always Occasionally Frequently Almost Always
Agree Agree Disagree Disagree Always Disagree Disagree

How often would you say the following events occur between you and your mate?

4.) Have a stimulating exchange of ideas_____
5.) Calmly discuss something together_____
6.) Work together on a project_____

0 1 2 3 4 5
Never Less than once or Once or Once a More
Once a month twice a month twice a week day often

The dots on the following line represent different degrees of happiness in your relationship. The middle point, “happy,” represents the degree of happiness of most relationships. Please circle the dot which best describes the degree of happiness, all things considered, of your relationship.

0 1 2 3 4 5 6
• • • • • • •
Extremely Fairly A little Happy Very Extremely Perfect
Unhappy Unhappy Unhappy Happy Happy

The following are ways people express love for each other. Now think of the ideal lover and the ways that they would express love to you. Rate each way of expressing love on how important it is to you as a way of your ideal lover expressing love to you. Fill in each blank with a number between 0 and 100 where 0 indicates "not at all important, and 100 indicates "as important as something can possibly be."
How often does your spouse demonstrate this behavior?
0_____100 Being there for special occasions. Very Often Often Sometimes Rarely Almost Never
0_____100 Being there in times of need Very Often Often Sometimes Rarely Almost Never
0_____100 Giving undivided attention to me Very Often Often Sometimes Rarely Almost Never

0_____100 Being with me Very Often Often Sometimes Rarely Almost Never
0_____100 Talking to me Very Often Often Sometimes Rarely Almost Never
0_____100 Doing things with me Very Often Often Sometimes Rarely Almost Never
0_____100 Sharing feelings Very Often Often Sometimes Rarely Almost Never
0_____100 Sharing experiences Very Often Often Sometimes Rarely Almost Never
0_____100 Sharing thoughts Very Often Often Sometimes Rarely Almost Never
0_____100 Spending time together Very Often Often Sometimes Rarely Almost Never
0_____100 Going places together Very Often Often Sometimes Rarely Almost Never
0_____100 Understanding me Very Often Often Sometimes Rarely Almost Never
0_____100 Expressing sympathy Very Often Often Sometimes Rarely Almost Never
0_____100 Giving gifts. Very Often Often Sometimes Rarely Almost Never
0_____100 Presents Very Often Often Sometimes Rarely Almost Never
0_____100 Flowers Very Often Often Sometimes Rarely Almost Never
0_____100 Candy Very Often Often Sometimes Rarely Almost Never
0_____100 Cards Very Often Often Sometimes Rarely Almost Never
0_____100 Acts of service Very Often Often Sometimes Rarely Almost Never
(serving, supporting, helping).
0_____100 Cooking Very Often Often Sometimes Rarely Almost Never
0_____100 Cleaning Very Often Often Sometimes Rarely Almost Never
0_____100 Caring for children Very Often Often Sometimes Rarely Almost Never
0_____100 Repairing things Very Often Often Sometimes Rarely Almost Never
0_____100 Yard work Very Often Often Sometimes Rarely Almost Never
0_____100 Doing things for me Very Often Often Sometimes Rarely Almost Never
0_____100 Caring for me when I am ill Very Often Often Sometimes Rarely Almost Never
0_____100 Words of affirmation Very Often Often Sometimes Rarely Almost Never
(telling, speaking, writing).
0_____100 Compliments Very Often Often Sometimes Rarely Almost Never
0_____100 Appreciation Very Often Often Sometimes Rarely Almost Never
0_____100 Encouragement Very Often Often Sometimes Rarely Almost Never
0_____100 Forgiveness Very Often Often Sometimes Rarely Almost Never
0_____100 Words that build me up Very Often Often Sometimes Rarely Almost Never
0_____100 Physical expression Very Often Often Sometimes Rarely Almost Never
(touching, kissing, caressing).
0_____100 Holding hands Very Often Often Sometimes Rarely Almost Never
0_____100 Kissing Very Often Often Sometimes Rarely Almost Never
0_____100 Massage Very Often Often Sometimes Rarely Almost Never
0_____100 Cuddling Very Often Often Sometimes Rarely Almost Never
0_____100 Loving touch Very Often Often Sometimes Rarely Almost Never
0_____100 Sexual intimacy Very Often Often Sometimes Rarely Almost Never



If you are interested in reading the findings of this study, results will be posted on http://bigfatresearchpaper.blogspot.com in the early summer of 2008.