SENSUALITY IN BLOOM -SEXUALITY QUESTIONNAIRE Question Title 1. How would you describe your RELATIONSHIP with your husband/boyfriend? Good? Bad? Stressful? Lonely? etc... Yes, I'm in a long-term relationship Please describe your current relationship here... OK Question Title 2. Are you happy with your SEX LIFE? Yes, I'm completely satisfied Sort of, but it could use some improvement No, I'm not satisfied We don't have sex anymore I'm not in a sexual relationship right now Other (please specify) OK Question Title 3. How would you rate your LIBIDO/SEX DRIVE? Excellent Good Fine, but I'd like for it to be better Not great I have zero desire for sex, but wish that I did I have zero desire for sex, and I'm okay with that Other/Explanation OK Question Title 4. What do you believe are the ISSUES/PROBLEMS affecting your sex life/sex drive? OK Question Title 5. What have you TRIED so far? Please check all that apply. Then in the comment section below, let me know if any of them helped you. Hormone therapy Herbal supplements Sex therapist Marriage counsellor Online course Reading books or blogs Google searches Nothing really Other/Comment OK Question Title 6. How is your HEALTH? Do you have health issues that need to be dealt with? Are you in shape? Are you overweight? Do you exercise? Are you living with a health condition? Are you taking medications? Please give as much detail as you can. OK Question Title 7. How would you rate your SELF-CONFIDENCE and SELF-ESTEEM? OK Question Title 8. What is your AGE? 20-30 years old 31-40 years old 41-50 years old 51-65 yrs old 65 + years old OK Question Title 9. When it comes to your sexuality, what are the EXACT results that you would like to achieve? For example, more intimacy and connection, more sexual pleasure, better orgasms or even having an orgasm? Please elaborate below. OK Question Title 10. If I could wave a magic wand and create a PRODUCT/SERVICE to help you with your sexuality, what would that look like? Please explain what you would need and want from it. For example, an online course, private consultation, detailed actions steps, etc. Would you like to ask specific questions and have them answered? Or would you prefer to have info provided and you can pick and chose according to what applies to you? OK DONE