Name:  ________________________________________                                    Back to 1st Session Forms

                                                                                                                 Press "Control P" to print

Whether you are aware of them or not, you have some bottom line requirements for you to want to be in your present relationship. Spend enough time to identify what they are for you. Write them down here, and then rate how much these needs are currently met using the 1-10 scale below. You should have at least two of them.

Not met at all                         Somewhat met                          Completely met

1           2           3           4           5           6           7           8           9           10

   Rating

1. _____ Requirement ___________________________________________________

_______________________________________________________________________

2. _____ Requirement ___________________________________________________

_______________________________________________________________________

3. _____ Requirement ___________________________________________________

_______________________________________________________________________

4. _____ Requirement ___________________________________________________

_______________________________________________________________________