ErectiStim TM by MyoStim ED Paid Registry Clinical Evaluation Study Survey

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* 1. Did you notice improvement of your sexual health after ErectiStim TM 8 treatment sessions?

Decline not improvement

No further decline but no improvement

Very Mild Modest improvement

Fair to Good Improvement

Good to Excellent Noticeable Improvement.

Decline not improvement

No further decline but no improvement

Very Mild Modest improvement

Fair to Good Improvement

Good to Excellent Noticeable Improvement.

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* 2. Did you experience improvement of erection hardness?

Got worse.

Did not get worse but did not get better.

Slightly harder erection.

Moderate improvement of erection hardness.

Highly noticeable good to great improvement of erection hardness.

Got worse.

Did not get worse but did not get better.

Slightly harder erection.

Moderate improvement of erection hardness.

Highly noticeable good to great improvement of erection hardness.

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* 3. Did you notice any change in penis enlargement?

Yes

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* 4. Did you notice a recovery of morning erections?

Noticed no improvement.

Did not notice either way.

Noted a slight improvement.

Noted a moderate improvement.

Noted good to excellent improvement.

Noticed no improvement.

Did not notice either way.

Noted a slight improvement.

Noted a moderate improvement.

Noted good to excellent improvement.

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* 5. Did your testosterone levels increase?

Lowered down.

Stayed the same.

Slight up tick.

Moderate increase.

Good to excellent increase.

Lowered down.

Stayed the same.

Slight up tick.

Moderate increase.

Good to excellent increase.

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* 6. Did your circulating Klotho levels increase?

Klotho levels decreased.

Klohto levels remained the same.

Klotho levels slightly increased about 1 to 5%.

Klotho levels improved > 5%.

Klotho levels increased dramatically > 10%

Klotho levels decreased.

Klohto levels remained the same.

Klotho levels slightly increased about 1 to 5%.

Klotho levels improved > 5%.

Klotho levels increased dramatically > 10%

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* 7. Would you recommend ErectiStim TM by MyoStim ED to others?

Would not.

Maybe but not as good as viagra.

Yes but with some reservations

Yes with a good endorsement.

Yes with an enthusiastic excellent endorsement.

Would not.

Maybe but not as good as viagra.

Yes but with some reservations

Yes with a good endorsement.

Yes with an enthusiastic excellent endorsement.

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* 8. Name

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* 9. Contact email

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* 10. Cell phone

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* 11. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number