Gender

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1. Gender

Age

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2. Age

Marital Status

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3. Marital Status

How would you rate your level of sexual desire?

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4. How would you rate your level of sexual desire?

Why do you have sex?

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5. Why do you have sex?

How many sexual contacts do you have per month with your partner?

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6. How many sexual contacts do you have per month with your partner?

Is your number of sexual contacts per month

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7. Is your number of sexual contacts per month

How would you rate the sexual aspects of your primary relationship?

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8. How would you rate the sexual aspects of your primary relationship?

If Female, Do you have conerns with

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9. If Female, Do you have conerns with

If Male, do you have

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10. If Male, do you have

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