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* 1. How old are you??

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* 2. How much PHYSICAL pleasure do you get from engaging in the following to climax? Eight is the best. (Select N/A if you do not engage in the act, or have not done it often enough or recently enough to rate it, or do not experaince climax this way. For intercourse assume any added stimulation commonly used.)

  1 2 3 4 5 6 7 8 N/A
Intercourse - In your favourite position you and your husband use.
Intercourse - In your LEAST favourite position you and your husband use.
Oral Sex (receiving)
Manual - his hand
Masturbation - your hand
Masturbation - with a toy
Him using a toy on you
Anal Sex
Rubbing your vulva against some part of his body

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* 3. In an average month, how often do you do each of these?

  0 0-1 1-2 3-5 6-8 9-12 13-16 17-21 more than 21
Intercourse - In your favourite position you and your husband use.
Intercourse - In your LEAST favourite position you and your husband use.
Oral Sex (receiving)
Manual - his hand
Masturbation - your hand
Masturbation - with a toy
Him using a toy on you
Anal Sex
Rubbing your vulva against some part of his body

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* 4. Optional Comment

T