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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.)

  1 2 3 4 5 6 7 8 N/A
Intercourse - In your favourite position you and your wife use.
Intercourse - In your LEAST favourite position you and your wife use.
Oral Sex (not deep throat)
Deep Throat Oral Sex
Manual - her hand
Masturbation - your hand
Masturbation - a sleeve or other toy
Her using a sleeve or other toy on you
Anal Sex
Rubbing against some part of her 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 wife use.
Intercourse - In your LEAST favourite position you and your wife use.
Oral Sex (not deep throat)
Deep Throat Oral Sex
Manual - her hand
Masturbation - your hand
Masturbation - a sleeve or other toy
Her using a sleeve or other toy on you
Anal Sex
Rubbing against some part of her body

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* 4. Optional Comment

T