This attachment style assessment form is built for mental health professionals who want a clear, organized way to explore how clients relate to intimacy, trust, independence, and emotional support. It combines basic contact details with targeted rating-scale questions that surface patterns connected to secure, anxious, avoidant, and fearful attachment styles.
The template starts with practical intake fields such as full name, email address, age range, and current relationship status, then moves into reflective statements about childhood caregiving, emotional expression, romantic closeness, fear of abandonment, and comfort with vulnerability. That structure helps respondents ease into the assessment before answering more personal questions.
Because the questions follow a consistent flow, this attachment style assessment form works well for therapy intake, pre-session reflection, psychoeducation, or ongoing relationship-focused counseling. You can use it as written or tailor the wording, scoring, and follow-up questions to match your clinical approach, specialty, or client population.
