Marriage Builders® Forms and Questionnaires

In the left-hand column, you will find forms and questionnaires currently available for you to use free of charge to strengthen your marriage. Use them only after you have read Dr. Harley's Basic Concepts.

First, complete the Emotional Needs Questionnaire and the Love Busters Questionnaire. They will help you understand what you are doing to make each other happy and make each other unhappy. Then, complete the Marital Problem Analysis. It will help you prioritize ways to improve your marriage. With the results of these three questionnaires in hand, complete the Memorandum of Agreement which is a promise by both of you to do what it will take to make your marriage terrific.

The Personal History Questionnaire will give you a bird's eye view into each other's history. If you have problems with financial support, complete the Needs and Wants Budget. And if you have problems with recreational companionship, complete the Recreational Enjoyment Inventory.

The Time for Undivided Attention Graph and Worksheet will help you hold yourselves accountable to follow one of my most important rules: The Policy of Undivided Attention.

Finally, the Marital Negotiation Worksheet will help you resolve your conflicts in a respectful and effective way.

These questionnaires and about sixty others are available in my workbook, 5 Steps to Romantic Love, which can be purchased in the Marriage Builders® Bookstore.

In order to view and copy these free questionnaires, you will need the latest version of Adobe Acrobat Reader, which is available for free by clicking on the "Adobe Reader" image below.

These questionnaires can be translated into 104 languages by using Google's free translation program. Go to and type or paste the webpage address for the questionnaire you want translated in the English box. It will appear in the translate box. Then identify the language you want and press "translate." The entire form will then appear in that language.

Adobe Acrobat Reader free download

Please note: All Marriage Builders® resources are available for PERSONAL USE ONLY and are fully copyrighted material. If you need to use these materials for other than personal use, you must have written permission. For more information contact our office at (651) 769-0978 or email us at

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