email@example.com firstname.lastname@example.org Tel +27 76 242 0027 BOOK GYNAE
INSTRUCTIONS: The below questions ask about your sexual feelings and responses during the past four weeks. Please answer as honestly and clearly as possible. Your responses will be kept completely confidential.
ONLY ONE OPTION PER QUESTION MAY BE SELECTED. ALL QUESTIONS RELATE TO YOUR EXPERIENCES DURING THE PAST FOUR WEEKS.