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Female Sexual Satisfaction Survey (Before Blissgevity)
1.
What is your age range?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65+
2.
I have had sexual activity within the last 24 hours:
Not at all
Once
More than once
3.
My sexual activity involved a partner:
Yes (Continue)
No (Skip to Question 8)
4.
My sexual activity involved intercourse:
Yes
No
5.
I initiated the sexual encounter
Yes (Skip to Question 8)
No (Continue)
6.
My partner initiated the sexual encounter:
Yes
No
7.
On a scale of 0 to 100 I was receptive. (I was ready or willing to receive favorably)
0 Not at All
Somewhat
100 Very Much So
Clear
8.
On a scale of 0 to 100 I typically become easily aroused:
0 Not at All
Somewhat
100 Very Much So
Clear
9.
On a scale of 0 to 100 my vaginal lubrication (wetness) is usually:
0 Absent
Average
100 A Great Deal
Clear
10.
I normally achieve orgasm during sexual activity:
Yes
No
11.
On a scale of 0 to 100 I achieve orgasm:
0 With Difficulty
100 Very Easily
Clear
12.
On a scale of 0 to 100 my sexual experience is normally:
0 Not Pleasurable
Somewhat Pleasurable
100 Very Pleasurable
Clear
13.
On a scale of 0 to 100 I typically find sex satisfying:
0 Not at All
Somewhat
100 Very Much So
Clear
14.
In your own words, how would you describe your regular sex life?
15.
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Email Address
