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1. Who are you with who has MS? (Required.)

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2. What kind of MS does this person live with? (Required.)

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3. Can your partner walk over 25 meters? (Required.)

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4. How physically healthy are you? (Required.)

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5. Are you sexually active? (Required.)

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6. How comfortable are you asking your doctor or nurse questions about sexual intimacy? (Required.)

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7. If you and your partner are having challenges with sex, which are your most important ones? (Required.)

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8. Have you ever tried aids to help your sexual function? If so, what? (Required.)

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9. Would you be interested in a resource (book, ebook, video, web-based) about MS and intimacy? (Required.)

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10. Do you have any suggestions for us? What would help you most? (Required.)

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