Rating Scale:  Rate each item on a scale from 0 - 10.

 

8-10:  GOOD - This area of my life is strong and would be an asset to my next relationship.

 

  5-7 :   OK -  This area needs work but, most likely, would not sabotage my next relationship.

 

0-4:    NEEDS WORK - This area could interfere with the success of my next relationship.

 

 

 

1. I KNOW WHAT I WANT. (____)

 

I have a clear vision for my life and relationship.  I can envision my perfect life in rich detail that feels strong, very real and keeps me motivated.

 

2. I  KNOW MY REQUIREMENTS. (___)

 

I have a written list of at least ten non-negotiable requirements that I use for screening potential partners.  I am clear that if any are missing, a relationship will not work for me.

 

3. I AM HAPPY AND SUCCESSFUL BEING SINGLE. (__)

 

I enjoy my life, my work, my family, my friends and my own company.  I am living the life that I want and I am not seeking a relationship out of desperation and need.

 

4.  I AM READY AND AVAILABLE FOR COMMITTMENT. (__)

 

I have no emotional or legal baggage from a previous relationship.  My schedule, commitments and lifestyle allow my availability to build a new relationship.

 

5.  I AM SATISFIED WITH MY WORK/CAREER. (____)

 

My work is fulfilling, supports my lifestyle and does not interfere with my availability for a new relationship.

 

6.  I AM HEALTHY IN MIND, BODY AND SPIRIT. (___)

 

My physical, mental or emotional health does not interfere with having the life and relationship that I want.  I am reasonably happy and feel good.

 

7.  MY FINANCIAL AND LEGAL BUSINESS IS HANDLED.(__)

 

I have no financial or legal issues that would interfere with having the life and relationship that I want.

 

8.  MY FAMILY RELATIONSHIPS ARE FUNCTIONAL. (__)

 

My relationships with my children, ex, siblings, parents and extended family do not interfere with having the life and relationship that I want.

 

9.  I HAVE EFFECTIVE DATING SKILLS. (__)

 

I initiate contact with people I want to meet and disengage from people who are not a match for me.  I keep my physical and emotional boundaries and balance my heart with my head with potential partners.

 

10. I HAVE EFFECTIVE RELATIONSHIP SKILLS. (__)

 

I understand relationships, can maintain closeness and intimacy, communicate authentically and assertively, negotiate differences positively, allow myself to trust and be vulnerable and can give and receive love with no emotional barriers.

 

TOTAL SCORE (____)