1.At what age did you first view pornography?

- Under 12

- 12–15

- 16–18

- 19–24

- 25 or older

- I have never viewed pornography

2.How often do you currently watch pornography?

- Daily

- Several times a week

- Once a week

- A few times a month

- Rarely

- Never

3.Has your pornography use changed over time?

- I watch more now than I used to

- I watch less now than I used to

- My use has stayed about the same

- I have never watched pornography

4.Do you feel your current pornography use affects your interest in sex with your partner?

- It increases my interest

- It decreases my interest

- No noticeable effect

- I don’t have a partner

- Not sure

5.How does sex with your partner compare to your experience with pornography?

- Sex with my partner is more satisfying

- Pornography is more satisfying

- They are equally satisfying

- I don’t have a partner

- Not sure

6.Do you and your partner ever watch pornography together?

- Yes, regularly

- Occasionally

- Rarely

- Never

- I don’t have a partner

7.How comfortable are you discussing pornography use with your partner?

- Very comfortable

- Somewhat comfortable

- Not very comfortable

- Not at all comfortable

- I don’t have a partner