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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. Would you say you are a Christian/Follower of Jesus?

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* 5. 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 spouse use.
Intercourse - In your LEAST favourite position you and your spouse use.
Reciving Oral Sex
Manual - Spouse's hand
Masturbation - Your hand
Spouse using a toy on you
Masturbation - With a toy
Mutual Matsturbation (Watching each other)
Anal Sex
Rubbing against some part of spouse's body

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* 6. 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 21-25 more than 25
Intercourse - In your favourite position you and your spouse use.
Intercourse - In your LEAST favourite position you and your spouse use.
Reciving Oral Sex
Manual - Spouse's
Masturbation - Your hand
Spouse using a toy on you
Masturbation - With a toy
Mutual Matsturbation (Watching each other)
Anal Sex
Rubbing against some part of spouse's body

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* 7. Optional Comments

T