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* 1. What is your age range?

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* 2. What is your current weight in pounds?

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* 3. What is your height in feet and inches? For example, if you are 5 feet and 4 inches, write 5’4”.

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* 4. I have had sexual activity within the last 24 hours:

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* 5. Did you consume Blissgevity on an empty stomach as recommended?

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* 6. How many pills did you consume:

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* 7. My sexual activity involved a partner:

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* 8. My sexual activity involved intercourse:

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* 9. I initiated the sexual encounter

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* 10. My partner initiated the sexual encounter:

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* 11. On a scale of 0 to 100 I was receptive. (I was ready or willing to receive favorably)

0 Not at All Somewhat 100 Very Much So

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* 12. I became easily aroused:

0 Not at All Somewhat 100 Very Much So

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* 13. On a scale of 0 to 100 my vaginal lubrication (wetness) was:

0 Absent Average 100 A Great Deal

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* 14. I normally achieve orgasm during sexual activity:

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* 15. On a scale of 0 to 100 I achieved orgasm:

0 With Difficulty 100 Very Easily

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* 16. How many orgasms did you experience:

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* 17. On a scale of 0 to 100 My sexual experience was:

0 Not Pleasurable Somewhat Pleasurable 100 Very Pleasurable

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* 18. On a scale of 0 to 100 I found sex satisfying:

0 Not at All Somewhat 100 Very Much So

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* 19. In your own words, how would you describe your sexual experience with Blissgevity?

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* 20. Thank you for taking the time to provide your feedback. Please provide your email address if you would like to receive future updates from Blissgevity including discount codes and promotions: