Do you have an active sexual partner at this time?
Is your partner satisfied with your erection?
Have you ever tried Viagra, Levitra or Cialis?
PRE-ASSESSMENT
Frequency
Everyday
Once a week
Once a month
Never
Firmness
Floppy
Limp
Semi-hard
Rock hard
Orgasm
Never
Rarely
Most times
Always
Performance
0-5 minutes
5-10 minutes
20 minutes
20+ minutes