Hey! We’re glad you’ve chosen to take this short “feelings” survey! We hope if needed, you can get on the road to feeling better right away!

Your privacy is valued. Your information will be kept confidential.

Where Can I Find Relief?

I spend about ______ of my time each day feeling irritated, frustrated, and angry.

I feel emotionally close to my spouse.

I feel that I have experienced a sense of being unconditionally loved in my life.

I treat my children with great love and respect.

I wonder if I made mistakes choosing the important relationships I have in my adult life.

I have experienced a lot of physical pain.

I feel that I am mostly:

When my kids do something wrong, I:

I know what my voice sounds like when I am kind and firm at the same time.

I have a loving relationship with my parents.

I worry about how others are perceiving me, and I do my best to impress people I'm meeting for the first time.

Good grades were/are very important to me.

I recognize when I have been unloving toward my spouse and kids and I quickly take responsibility for my words and behaviors.

I have experienced multiple traumatic events in my lifetime.

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