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* 1. You identify more as:

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* 2. Your age range:

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* 3. Relationship Status. You are:

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* 4. When it comes to intimacy, sex, and having a fulfilling romantic relationship, what is your biggest challenge?

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* 5. Ideal scenario: What do you really want? What do you crave? What would feel really meaningful and satisfying?

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* 6. Worst-case scenario: What do you think will happen to you if things remain the same, you don’t get what you want or the situation gets worse?

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* 7. What would help? What would be the ideal practical solution to help you resolve this issue or make the pain go away?

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* 8. How would your life look like, how would it feel if this ideal solution would give you what you dream of?

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* 9. If you could ask the top experts on the planet about intimacy, sex, and romantic relationship, what would be your number 1 most burning question?

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* 10. Your Name and Email Address (Optional)