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* 1. What is your age range?

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

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* 3. My sexual activity involved a partner:

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* 4. My sexual activity involved intercourse:

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* 5. I initiated the sexual encounter

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* 6. My partner initiated the sexual encounter:

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* 7. 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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* 8. On a scale of 0 to 100 I typically become easily aroused:

0 Not at All Somewhat 100 Very Much So

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* 9. On a scale of 0 to 100 my vaginal lubrication (wetness) is usually:

0 Absent Average 100 A Great Deal

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* 10. I normally achieve orgasm during sexual activity:

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* 11. On a scale of 0 to 100 I achieve orgasm:

0 With Difficulty 100 Very Easily

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* 12. On a scale of 0 to 100 my sexual experience is normally:

0 Not Pleasurable Somewhat Pleasurable 100 Very Pleasurable

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* 13. On a scale of 0 to 100 I typically find sex satisfying:

0 Not at All Somewhat 100 Very Much So

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* 14. In your own words, how would you describe your regular sex life?

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* 15. 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: