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1. How confident are you in your ability to keep an erection?
   a. Very low
   b. Low
   c. Moderate
   d. High
   e. Very high
2. When you are sexually aroused to the point of an erection, how often is the erection capable of penetration?
   a. Almost never or never
   b. A few times (much less than half the time)
   c. Sometimes (about half the time)
   d. Most times (much more than half the time)
   e . Almost always or always
3. How often do you lose the erection after penetration?
   a. Did not attempt intercourse
   b. Almost never or never
   c. Sometimes (about half the time)
   d. Most times (much more than half the time)
   e. Almost always or always
4. How difficult is it to keep an erection after penetration to complete intercourse?
   a. Did not attempt intercourse
   b. Very difficult
   c. Difficult
   d. Slightly difficult
   e. Not difficult
5. How often is sexual intercourse satisfactory to you?
   a. Did not attempt intercourse
   b. Almost never or never
   c. A few times (much less than half the time)
   d. Sometimes (about half the time)
   e. Most times (much more than half the time)