What should we call you?
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How old are you?
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How tall are you?
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How much do you weigh?
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Right now, how do you feel about your sexual health?
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I’m a rockstar
It could be better
There are noticeable problems
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Do you have any specific concerns?
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Trouble getting it up
New curve of bend
Softer than I’d like to be
None of these
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Are you in a relationship?
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Single
In a relationship
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Have you noticed a decline in your sexual performance as you’ve gotten older?
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Not yet
Somewhat
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From 1 to 5, how do you rate your confidence in your ability to get and keep an erection?
1 = Not being confident ... 5 = Confident
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Overall, how healthy is your diet?
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Very healthy
So-so
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What's your email?
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What's your cell phone number?
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Where are you located?
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