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* 1. What is your gender?

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* 2. How old are you??

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* 3. How long have you been married?

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* 4. How important is sex to you?

  1 2 3 4 5 6 7
How important is sex to you? 1 = not at all, 7 = extremely

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* 5. How would you rate your marriage overall?

  1 2 3 4 5 6 7
How would you rate your marriage overall? 1 = horrible, 7 = incredible

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* 6. How would you rate sex life?

  1 2 3 4 5 6 7
How would you rate sex life? 1 = horrible, 7 = incredible

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* 7. Optional Comments

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