In order to compile a personal exercise strategy, some information regarding your sexual feelings and behaviour is required.

No names or contact details are required except for an email address for correspondence purposes; we suggest that you use an anonymous email address.

This questionnaire is intended to help you describe your feelings and the type of change you would like to undergo.

To view an example questionnaire please click here.

	What is your email address?
Q1	What is your age or age group?
Q2	What kinds of sexual activities have you decided you want to stop doing but still struggle with?
Q3	What kinds of sexual reactions of your body do you want to reduce or eliminate?
Q4	What sexual reactions do you want to experience instead?
Q5	What kinds of feelings do you want to stop feeling?
Q6	What kinds of feelings do you want to feel instead of the unwanted feelings?
Q7	Have you been sexually abused? If so you may qualify for state sponsorship (New Zealand Citizens only).
Q8	Why do you want to change the way you feel and behave?
Q9	Assuming you are satisfied with the program supplied, how long are you prepared to work at it?
Q10	What treatment have you tried before?
Q11	What treatment (e.g. prescription drugs, therapy etc.) are you currently receiving if any?
Q12	Do you have any conditions or limitations that prevent you from doing physical exercise?
Q13	If you are currently involved in a sexual relationship, describe the person without giving any names?

A reply will probably reach you within one week of submitting this questionnaire. The reply will include a few more questions to clarify our understanding of your situation and goals. As soon as we are both clear about your needs and goals for the intended program we will compile and send the recommended strategy.

Consultations for developing a personalised program are free. Programs supplied for a fee of US$75.00 each. Anonymous payments can be arranged.