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The MOTHER/Daughter Experience
Mother's Survey
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Which age category do you belong to?
Under 18
18-25
26-35
36-45
46-55
56-65
65+
Other:
Clear selection
How would you describe your relationship with your DAUGHTER?
Your answer
What is your favorite thing about your DAUGHTER?
Your answer
How often do you talk to your DAUGHTER?
Less than once a year
Less than once a month
A few times a month
Every week
Every day
Other:
Clear selection
How often do you argue with your DAUGHTER?
Never
Not too often
Regularly
Every time we talk
Other:
Clear selection
What do you argue about?
Your answer
Do you tell your DAUGHTER you love her?
Yes
No
Other:
Clear selection
Do you feel judged by your DAUGHTER?
Yes
No
Clear selection
Do you wish you were closer to your DAUGHTER?
Yes
No
Other:
Clear selection
Do you admire your DAUGHTER? Why or Why not?
Your answer
Do you feel supported by your DAUGHTER?
Always
Sometimes
Rarely
Never
Other:
Clear selection
Do you feel controlled by your DAUGHTER?
Not at all
Sometimes
Always
Other:
Clear selection
Does your DAUGHTER listen to you?
Yes
No
Clear selection
Do you feel appreciated by your DAUGHTER?
Always
Usually
Sometimes
Never
Other:
Clear selection
How often do you do activities with your DAUGHTER?
Never
Yearly
Monthly
Weekly
Daily
Other:
Clear selection
Do you share your problems with your DAUGHTER?
Yes
No
Sometimes
Clear selection
Do you think your DAUGHTER understands you?
Yes
No
Sometimes
Clear selection
Do you trust your DAUGHTER?
Yes
No
With some things
Clear selection
Do you usually agree or disagree with your DAUGHTER?
Disagree
Neutral
Agree
Clear selection
Do you enjoy spending time with your DAUGHTER?
As much as I can get
Only in small amounts
No
Other:
Clear selection
Do you usually feel drained or energized after being with your DAUGHTER?
Your answer
Do you talk about sexuality with your DAUGHTER?
Yes
No
Clear selection
Do you talk about your personal relationships with your DAUGHTER?
Yes
No
Clear selection
Do you talk about work with your DAUGHTER?
Yes
No
Clear selection
If you could change one thing about your DAUGHTER, what would it be?
Your answer
Do you have anything you want to share with your DAUGHTER, but find it too hard?
Your answer
Do you talk about health with your DAUGHTER?
Yes
No
Clear selection
Do you talk about death with your DAUGHTER?
Yes
No
Clear selection
Do you like your DAUGHTER?
Yes
No
Clear selection
How did/do you discipline your Daughter?
Your answer
How did your Mother discipline you?
Your answer
How were you taught to deal with disappointment?
Your answer
In what way would you like to be more like your DAUGHTER?
Your answer
Is there something you want from your Daughter that you are not getting?
Your answer
Would you attend a workshop or retreat with your Daughter?
Yes
No
Maybe
Clear selection
Is there anything else you would like to add?
Your answer
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