Make two copies of this. Both you and your spouse should fill them out privately. Then exchange papers with each other and discuss.

YES   NO

____   ____ Do I live a holy life?
____   ____ Do I have a daily prayer-life?
____   ____ Do I pray daily for my spouse?
____   ____ Am I a role-model to my spouse?
____   ____ Is my thought-life pure?
____   ____ Do I study the Word of God daily?
____   ____ Do I have sincere love for my spouse?
____   ____ Am I prepared to serve my spouse physically?
____   ____ Am I prepared to serve my spouse emotionally?
____   ____ Am I prepared to serve my spouse spiritually?
____   ____ Do I have a goal to demonstrate love for my spouse today?
____   ____ Do I attain my goal each day?
____   ____ Do I maintain open communication with him/her daily?
____   ____ Do I allow television to interfere with communication?
____   ____ Do I focus clearly on her/his happiness?
____   ____ Have I cleaned up after myself to minimize housework?
____   ____ Do I encourage my spouse in his/her endeavors?
____   ____ Does my body-language express love as I listen to him/her?
____   ____ Do I phone, fax or e-mail my honey from work?
____   ____ Am I a spiritual role-model to my spouse?
____   ____ Do I attend Sunday School with my mate?
____   ____ Am I faithful to my pastor?
____   ____ Am I faithful to attend church services?
____   ____ Do I tithe consistently?
____   ____ Do I get up early enough on Sunday mornings to be on-time?
____   ____ Do I enjoy being alone with God?
____   ____ Is my heart ready to receive fresh truth from God?
____   ____ Is my spirit sweet toward my spouse when I get up each day?
____   ____ Do I greet my spouse with a smile and fresh breath each day?
____   ____ Do I look forward to “dates” with my spouse?
____   ____ Do I assist with the housework?
____   ____ Do I miss my spouse when absent from her/him?

Discuss your findings in a spirit of love and affection.


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