Thank you for filling out this survey!

The answers you provide will be anonymous and only utilized for research regarding how often sexual issues are discussed in healthcare. The cumulative percentages on questions will be used in order to discuss these issues at Stanford University's Medicine X conference in the next month.

If you have any issues or would like to talk further in person, please email me at kirsten@chronicsex.org.

Thanks again!
Kirsten Schultz
Chronic Sex

Please note that when I say 'HCPs,' I mean healthcare providers. This could be a physician, nurse, medical assistant, physical therapist, or another medical professional directly involved in your care.

Quality of Life (QOL) issues include relation to self, relationships with others, stress, life events, ability to perform daily tasks (cooking, cleaning, bathing, bathrooming, etc).

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* 1. Have any of your physicians or other healthcare providers talked to you about sex or sexual issues?

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* 2. Do your HCPs seem comfortable asking you questions related to sex?

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* 3. Do you feel comfortable asking your HCPs about sex/related function?

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* 4. Do your HCPs try to answer questions you have about sex/related things?

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* 5. Have any HCPs discussed effects on sex or fertility your medications or treatments may have?

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* 6. Has any HCPs discussed effects on sex or fertility your diagnoses may have?

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* 7. When sex or sexual issues are discussed in an appointment, who usually brings it up first?

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* 8. Are your HCPs receptive to hearing concerns about your Quality of Life (QOL)?

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* 9. When Quality of Life (QOL) issues are discussed in an appointment, who usually brings it up first?

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* 10. Where do you feel most comfortable getting information on sex/sexuality in regards to illness/disability?

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