This survey is anonymous. Answer all that apply — preferably in private, away from your spouse.
FBC Burleson — for our coming series on marriage & family. Place in the offering box/plate or return to the
church office before August 12. No one will see these except Pastor Chris, Billy Beacham (& an assistant to tabulate).
Write on the back if you need more room — more information is preferred!
Circle one:MaleFemale
Circle one:SingleMarriedIf single, skip to “For women / For men” below.
If married, how many years? Circle one:
5 or less6–1011–2021–3031–4041–5050+
Rate your marriage, 1–10 (10 being best):
How would your spouse rate it?
Other than God, is there anything that sometimes seems more important than your marriage, for you or your spouse?Ideas: job, kids, hobby, sports, money, social media
For you?
For your spouse?
Rate physical intimacy in your marriage, 1–10 (10 being best):
Do you wish it was … (circle one)more frequentless frequentlike it as it is
What would your spouse prefer? (circle one)morelessas is
Any other comments/questions about this area?
Ask the question you never had the nerve to ask, no matter how far out there it is. Remember, this survey is anonymous.
What are the two main sources of conflict in your marriage? Please explain.
Ideas: work, finances, parenting, communication, in-laws, sex, anger, spiritual/values/beliefs, stress, boredom, alcohol/drugs, jealousy, expectations, gets defensive, drifting apart, lack of romance/emotional intimacy, porn
1. 2.
What could you do to improve your marriage?
What could your spouse do to improve your marriage?
For women: I wish you would tell the men…
For men: I wish you would tell the women…
If you have children, what is your biggest challenge in parenting?
Do you feel equipped to disciple your children?Please explain.
What topic(s) would you like addressed in this marriage/family series?
How happy are you in your marriage? (10 being best)
You You think spouse
How teachable (willing to change, grow) are you & your spouse, related to your marriage? 1–10 (10 being most teachable)
You Your spouse
Anything else you would like to ask or state related to marriage & family?
Check one:Please do not read anything I wrote. It might bother my spouse.You can comment on this, but please disguise it.You are welcome to read or comment on anything I wrote.Other comments related to this
Printing from a phone? Use the PDF. Phone print dialogs ignore this
page’s margin settings and add their own, which can split the survey
across two sheets. The PDF is already laid out as one page, so it prints
the same everywhere.
From a computer, either works. In the print dialog, turn
off headers & footers and set margins to Default or
Minimum.