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Sex and Being Married Survey
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Use the drop down arrow to select the response that best relates to your current situation.

What is your gender?
What is your age?
Where do you currently live?
Please estimate your annual household income ( US dollars).
Which of the following best describes your occupation?
How long have you been married?
What is your sexual preference?
How many children do you have?
How frequently do you have sex?
How would you compare your current sex life to your first year of marriage?
Have you or your significant other had any form of permanent birth control?
If Yes, what type of permanent birth control have you or your significant other had? (then skip next 2 questions)
Do you currently use some form of birth control?
What form of birth control do you most often use:
Is your partner aware of your sexual fantasies?
Have you ever paid for sexual acts?
Do you subscribe to any source relating to sex?
For each of the following statements, use the criteria listed that best describes your views towards sex.
Strongly Agree Agree Unsure Disagree Strongly Disagree
My use of protection depends upon my partner's willingness
I often fantasize about having sex with other people
Sex is very important to me
I enjoy sex
I am satisfied with my current level of sexual activity
Intimacy is more important than sex
Who I am with is more important than our sexual performance
I waited until I was married to have sex
I have negative feelings towards sex
I am okay with other's being homosexual
Religion plays a strong factor in my sexual lifestyle
List the types of sexual activities you frequently engage in (choose all that apply)
Kissing Holding Hands
Hugging Fondling
Oral Sex Giving Oral Sex Receiving
Intercourse Anal Sex
Multiple Partners S&M
Hard Core Watching Sexual Activity
Masturbation Other
What factors adversely affect your sex life? (choose all that apply)
Career Children
Stress Lack of interest
Other interests Childhood issues
Relationship problems Religious beliefs
What sources have you used relating to sex? (choose all that apply)
None Magazines
Video Internet
Strip Clubs XXX Theatres
Thank you for taking the time to complete this survey. Select Submit Survey now to send your responses to us.

This questionnaire was created by Perseus SurveySolutions for the Web.

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