Mens Testosterone Screening Questions

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Testosterone Screening

Please complete the following form to the best of your abilities.

22Questions

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1
Enter your name * This field is required.
2
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3
Rate your level of libido or sex drive
Horrible (1)
Bad (2)
Fair (3)
Good (4)
Excellent (5)
Answer
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Horrible (1)
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Bad (2)
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Fair (3)
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Good (4)
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Excellent (5)
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4
Rate your erection strength & effectiveness
Horrible (1)
Bad (2)
Fair (3)
Good (4)
Excellent (5)
Answer
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Horrible (1)
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Bad (2)
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Fair (3)
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Good (4)
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5
How do you rate your confidence that you could get and keep an erection?
Very low (1)
Low (2)
Moderate (3)
High (4)
Very high (5)
Answer
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Very low (1)
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Low (2)
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Moderate (3)
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High (4)
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Very high (5)
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6
When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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7
During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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Almost always/always (5)
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8
During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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Almost always/always (5)
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9
When you attempted sexual intercourse, how often was it satisfactory for you?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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Almost always/always (5)
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10
Rate your energy levels
Always tired (1)
Tired most of the days (2)
I have fair energy (3)
Satisfactory energy (4)
I’m always energetic (5)
Answer
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Always tired (1)
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Tired most of the days (2)
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I have fair energy (3)
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Satisfactory energy (4)
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I’m always energetic (5)
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11
Rate the quality of your muscle health (low injury potential/strength/stamina/recovery)
Horrible (1)
Bad (2)
Fair (3)
Good (4)
Excellent (5)
Answer
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Horrible (1)
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Bad (2)
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Fair (3)
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Good (4)
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Excellent (5)
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12
Speed to ejaculation satisfaction
Horrible (1)
Bad (2)
Fair (3)
Good (4)
Excellent (5)
Answer
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Horrible (1)
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Bad (2)
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Fair (3)
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Good (4)
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Excellent (5)
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13
How difficult is it for you to delay ejaculation?
Not difficult at all (0)
Somewhat difficult (2)
Moderate difficult (3)
Very difficult (4)
Extremely difficult (5)
Answer
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Not difficult at all (0)
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Somewhat difficult (2)
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Moderate difficult (3)
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Very difficult (4)
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Extremely difficult (5)
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14
Do you ejaculate before you want to?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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15
Do you ejaculate with very little stimulation?
Almost never/never (1)
A few times (2)
About half the time (3)
Most times (4)
Almost always/always (5)
Answer
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Almost never/never (1)
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A few times (2)
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About half the time (3)
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Most times (4)
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Almost always/always (5)
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16
Do you feel frustrated because of ejaculating before you want to?
Not at all (1)
Slightly (2)
Moderately (3)
Very (4)
Extremely (5)
Answer
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Not at all (1)
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Slightly (2)
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Moderately (3)
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Very (4)
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Extremely (5)
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17
How concerned are you that your time to ejaculation leaves your partner unfulfilled?
Not at all (1)
Slightly (2)
Moderately (3)
Very (4)
Extremely (5)
Answer
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Not at all (1)
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Slightly (2)
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Moderately (3)
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Very (4)
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Extremely (5)
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18
Rate your level of general sense of moods and happiness in life
Highly depressed (1)
Fairly depressed (2)
Depressed (3)
Not depressed (4)
Very happy (5)
Answer
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Highly depressed (1)
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Fairly depressed (2)
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Depressed (3)
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Not depressed (4)
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Very happy (5)
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19
Rate your quality of job performance
Always low quality and under performing (1)
Frequently low quality (2)
Fair (3)
Good quality (4)
Excellent quality (5)
Answer
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Answer
Always low quality and under performing (1)
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Frequently low quality (2)
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Fair (3)
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Good quality (4)
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Excellent quality (5)
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20
Rate your sleep quality
Always have sleep problems (1)
Frequent sleep problems (2)
I get average sleep (3)
I have good sleep quality (4)
I have excellent sleep quality (5)
Answer
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Always have sleep problems (1)
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Frequent sleep problems (2)
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I get average sleep (3)
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I have good sleep quality (4)
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I have excellent sleep quality (5)
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21
Rate your physical endurance level
Horrible (1)
Bad (2)
Fair (3)
Good (4)
Excellent (5)
Answer
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Horrible (1)
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Bad (2)
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Fair (3)
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Good (4)
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Excellent (5)
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22
Rate your frequency level of partaking in your favorite hobbies
Always avoiding or delaying hobbies (1)
Frequently avoiding hobbies (2)
50:50 (3)
I am involved enough in my hobbies (4)
I always keep up and involved in hobbies and activities that keep me happy (5)
Answer
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Answer
Always avoiding or delaying hobbies (1)
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Frequently avoiding hobbies (2)
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50:50 (3)
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I am involved enough in my hobbies (4)
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I always keep up and involved in hobbies and activities that keep me happy (5)
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