Premarital Culture Survey

Have you been married previously?

Are your parents still married

yes

no

If your parents are no longer married please indicate reason below

Mother or father deceased. How old were you when they passed?

Parents never married

Parents currently separated

Parents are same sex couple not legally able to marry in their state of residence

My home growing up felt

predictable and secure

full of change and volatile

happy but chaotic at times

peaceful and easy going

What statement best fits your level of contact with your family of origin?

We talk frequently during the week and usually see each other 3 or more times a week

My family lives a distance away but we talk on the phone a few times per week

I am estranged from my parents

I am estranged from my parents and siblings

I am frequently getting together with my immediate family and my extended family we are extremely close

I see my family 1-2 times per month

When I was a kid,communication in my family was most frequently

as needed we weren’t big talkers

mostly around things that needed fixing or weren’t going well

lots of joking and verbal sparring

critical and negative

affirming and loving

unpredictable never knew when something would explode

lots of blaming and shaming

mostly kind and cordial with shouting only rarely

In your family who did the lion’s share of chores and tasks for the homes upkeep?

Mom

Dad

even between Mom and Dad

the hired staff

Mom and Dad with the kids having chores

We lived with extended family so it is difficult to tell

My pace and feel of my house growing up was most described as

full of people and loud but the more the merrier

calm and orderly

chaotic busy and disheveled

lots of pleasant family activity but pretty low key

If my family has conflicts with my spouse I will likely

mediate

my spouse has to find their way to relate so I stay out of it

encourage my spouse to let it go and not address it

support my spouses position even if I disagree with it

support my family even if I disagree with them

stay clear of everyone I hate conflict!

I would say I had a closer relationship with my