Erectile Dysfunction Assessment
This confidential assessment helps determine the severity of erectile dysfunction and whether treatment may be appropriate for you.
Question 1 of 8
How do you rate your confidence that you could achieve and maintain an erection?
Question 2 of 8
When you had erections with sexual stimulation, how often were they firm enough for penetration?
Question 3 of 8
During sexual intercourse, how often were you able to maintain your erection after penetration?
Question 4 of 8
During sexual intercourse, how difficult was it to maintain your erection to completion?
Question 5 of 8
When you attempted sexual intercourse, how often was it satisfactory for you?
Question 6 of 8
How long have you been experiencing difficulties with achieving or maintaining erections?
Question 7 of 8
Have you tried any treatments for erectile dysfunction previously?
Question 8 of 8
Do you have any of the following conditions? (Select all that apply)
