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* 1. What is your gender?

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* 2. How old are you?

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* 3. How long have you and your spouse been married?

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* 4. How does the sexual frequency in your marriage (any form of sex with your spouse) compare to your ideal frequency?

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* 5. How long have you and your spouse been married?

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* 6. In an average week, how often do you and your spouse have some form of sex?

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* 7. Optional Comments

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