This optional shared page gives each partner a separate space to notice a good moment, something difficult, a specific request and an appreciation. Neither person has to fill in every row or share anything they prefer to keep private.
If both want to take part, alternate speaking and listening without treating the page as a scorecard. The shared section invites you to agree on one small action and, only if you both wish, a time for another check-in; it does not replace professional support.
Optional and private. Use this to be clear and kind, not to keep score. Skip any section. If you feel unsafe or afraid of your partner, a domestic abuse service or trusted person can help you consider your options. In immediate danger, contact local emergency services. This is not couples therapy or professional advice. If someone monitors your device or belongings, consider whether keeping or sharing this page is safe for you.
