FSD survey

Thank you for agreeing to participate in this survey. We know that more than 43% of women report sexual problems and 12% likely meet the criteria for a diagnosis of a female sexual disorder (FSD), yet most of these women do not undergo formal assessment. The purpose of this survey is to obtain data that will better explain the gap between a prevalent complaint and health care providers’ underutilization of screening for sexual problems.

1) Which of the following best describes you?

ObGyn   Internal medicine/Family practice physician   Nurse practitioner   Physician assistant   Urologist   Other (please specify)

If you selected other, please specify:

2) How old are you?

25-35 years   36-45 years   46-55 years   56-65 years   Over 65 years

3) How many years have you been in practice?

Less than 5   6-10   11-15   16-20   More than 20

4) What is your gender?

Male   Female

5) Which of the following best describes your practice?

Solo   Multispecialty group   Single-specialty group   Academic institution   Other (please specify)

If you selected other, please specify: