770.649.0094
CWA 4343 Shallowford Rd #150, Marietta,GA 30062
ACFRD 5685 Lake Placid Dr NE, Atlanta, GA 30342
VIRTUAL CONSULT
TEXT US
Home Page
Meet Dr. Kelley
Weight Loss
Lean Body Program
Wellness
Female Hormone Balance
Male hormone balance
Thyroid-the master regulator
Adrenal Health
IV Therapy
GI Health
Intimate Wellness
O Shot
P Shot
Vampire winglift
V fit Plus
Procedures
Xeomin Wrinkle relaxer
Sculptra-CWA Precise Sculpt
Wrinkle Fillers- Contour and Rejuvenate
Radiesse-Contour, Lift and Tighten
Microneedling for beautiful and healthy skin
Exilis Elite Facial Skin Tightening
PRP Hair Therapy
Pre and Post PRP hair Instructions
PRP Injections
O Shot
Testimonials
770.649.0094
CWA 4343 Shallowford Rd #150, Marietta,GA 30062
ACFRD 5685 Lake Placid Dr NE, Atlanta, GA 30342
VIRTUAL CONSULT
TEXT US
Home Page
Meet Dr. Kelley
Weight Loss
Lean Body Program
Wellness
Female Hormone Balance
Male hormone balance
Thyroid-the master regulator
Adrenal Health
IV Therapy
GI Health
Intimate Wellness
O Shot
P Shot
Vampire winglift
V fit Plus
Procedures
Xeomin Wrinkle relaxer
Sculptra-CWA Precise Sculpt
Wrinkle Fillers- Contour and Rejuvenate
Radiesse-Contour, Lift and Tighten
Microneedling for beautiful and healthy skin
Exilis Elite Facial Skin Tightening
PRP Hair Therapy
Pre and Post PRP hair Instructions
PRP Injections
O Shot
Testimonials
Home Page
Meet Dr. Kelley
Weight Loss
Lean Body Program
Wellness
Female Hormone Balance
Male hormone balance
Thyroid-the master regulator
Adrenal Health
IV Therapy
GI Health
Intimate Wellness
O Shot
P Shot
Vampire winglift
V fit Plus
Procedures
Xeomin Wrinkle relaxer
Sculptra-CWA Precise Sculpt
Wrinkle Fillers- Contour and Rejuvenate
Radiesse-Contour, Lift and Tighten
Microneedling for beautiful and healthy skin
Exilis Elite Facial Skin Tightening
PRP Hair Therapy
Pre and Post PRP hair Instructions
PRP Injections
O Shot
Testimonials
Sexual Function Questionnaire
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>
Sexual Function Questionnaire
General Information
Name:
Date
Sexual Function Questionnaire
How often do you feel distressed about your sex life?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel unhappy about your sexual relationship?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel guilty about your sexual difficulties?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel frustrated by your sexual problems?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel stressed about sex?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel inferior because of sexual problems?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel worried about sex?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel sexually inadequate?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel regrets about your sexality?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel embarrassed about your sexual problems?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel angry about your sex life?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel dissatisfied with your sex life?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
How often do you feel bothered by low desire?
0 Never
1 Rarely
2 Occasionally
3 Frequently
4 Always
Do you affirm that you have answered all questions truthfully and to the best of your knowledge?
*
Yes
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