I feel fulfilled in my family relationships.

True

False

N/A

I feel fulfilled in my friendships.

True

False

N/A

I feel fulfilled in my intimate relationship.

True

False

N/A

I feel connected to my spouse/partner emotionally and physically.

True

False

N/A

I feel respected at work.

True

False

N/A

I feel capable to create positive changes in my life.

True

False

N/A

I feel good about the man I am and how I show up in life.

True

False

N/A

I feel I receive attention and affection by those I love.

True

False

N/A

I feel that it’s easy to be affectionate with those I care about.

True

False

N/A

I feel both myself and my partner are sexually fulfilled.

True

False

N/A

I feel like others acknowledge the good man I am.

True

False

N/A

I feel comfortable verbally sharing my love towards those I care about.

True

False

N/A

I feel honored and respected for being a man by my spouse/partner.

True

False

N/A

I feel comfortable sharing how I truly feel with my spouse/partner.

True

False

N/A

I feel that my spouse/partner is a soft place to turn to when I feel stressed or overwhelmed.

True

False

N/A

I feel celebrated for who I am by my spouse/partner.

True

False

N/A

I feel fulfillment through my work, career, or a devoted way I spend my free time.

True

False

N/A

I feel a loving connection to a Higher Power that loves me unconditionally for who I am.

True

False

N/A

I feel I am able to provide, protect, and support others in a way that makes me proud.

True

False

N/A

I feel comfortable bringing up topics, even when I know it will be challenging for my partner to initially hear.

True

False

N/A

I feel deeply loved for who I am.

True

False

N/A

Anything else you would like to share?

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